2024 ICD-10-CM Diagnosis Code T38.804A

Poisoning by unspecified hormones and synthetic substitutes, undetermined, initial encounter

ICD-10-CM Code:
T38.804A
ICD-10 Code for:
Poisoning by unsp hormones and synthetic sub, undet, init
Is Billable?
Yes - Valid for Submission
Chronic Condition Indicator: [1]
Not chronic
Code Navigator:

Code Classification

  • Injury, poisoning and certain other consequences of external causes
    (S00–T88)
    • Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances
      (T36-T50)
      • Poisoning by, adverse effect of and underdosing of hormones and their synthetic substitutes and antagonists, not elsewhere classified
        (T38)

T38.804A is a billable diagnosis code used to specify a medical diagnosis of poisoning by unspecified hormones and synthetic substitutes, undetermined, initial encounter. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.

T38.804A is an initial encounter code, includes a 7th character and should be used while the patient is receiving active treatment for a condition like poisoning by unspecified hormones and synthetic substitutes undetermined. According to ICD-10-CM Guidelines an "initial encounter" doesn't necessarily means "initial visit". The 7th character should be used when the patient is undergoing active treatment regardless if new or different providers saw the patient over the course of a treatment. The appropriate 7th character codes should also be used even if the patient delayed seeking treatment for a condition.

Unspecified diagnosis codes like T38.804A are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.

Clinical Classification

Clinical CategoryCCSR Category CodeInpatient Default CCSROutpatient Default CCSR
External cause codes: intent of injury, undeterminedEXT023N - Not default inpatient assignment for principal diagnosis or first-listed diagnosis.N - Not default outpatient assignment for principal diagnosis or first-listed diagnosis.
External cause codes: poisoning by drugEXT014N - Not default inpatient assignment for principal diagnosis or first-listed diagnosis.N - Not default outpatient assignment for principal diagnosis or first-listed diagnosis.
Poisoning by drugs, initial encounterINJ022Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.

Coding Guidelines

When coding a poisoning or reaction to the improper use of a medication (e.g., overdose, wrong substance given or taken in error, wrong route of administration), first assign the appropriate code from categories T36-T50. The poisoning codes have an associated intent as their 5th or 6th character (accidental, intentional self-harm, assault and undetermined. If the intent of the poisoning is unknown or unspecified, code the intent as accidental intent. The undetermined intent is only for use if the documentation in the record specifies that the intent cannot be determined. Use additional code(s) for all manifestations of poisonings.

The appropriate 7th character is to be added to each code from block Poisoning by, adverse effect of and underdosing of hormones and their synthetic substitutes and antagonists, not elsewhere classified (T38). Use the following options for the aplicable episode of care:

  • A - initial encounter
  • D - subsequent encounter
  • S - sequela

Convert T38.804A to ICD-9-CM

  • ICD-9-CM Code: 962.9 - Poisoning hormon NEC/NOS
    Combination Flag - Multiple codes are needed to describe the source diagnosis code. Correct coding should be done based on contextual judgment.
  • ICD-9-CM Code: E980.4 - Undet pois-med agnt NEC
    Combination Flag - Multiple codes are needed to describe the source diagnosis code. Correct coding should be done based on contextual judgment.

Table of Drugs and Chemicals

The parent code T38.804 of the current diagnosis code is referenced in the Table of Drugs and Chemicals, this table contains a classification of drugs, industrial solvents, corrosive gases, noxious plants, pesticides, and other toxic agents.

According to ICD-10-CM coding guidelines it is advised to do not code directly from the Table of Drugs and Chemicals, instead always refer back to the Tabular List when doing the initial coding. Each substance in the table is assigned a code according to the poisoning classification and external causes of adverse effects. It is important to use as many codes as necessary to specify all reported drugs, medicinal or chemical substances. If the same diagnosis code describes the causative agent for more than one adverse reaction, poisoning, toxic effect or underdosing, utilize the code only once.

Substance Poisoning
Accidental
(unintentional)
Poisoning
Accidental
(self-harm)
Poisoning
Assault
Poisoning
Undetermined
Adverse
effect
Underdosing
HormoneT38.801T38.802T38.803T38.804T38.805T38.806
Hormone
  »adrenal cortical steroids
T38.801T38.802T38.803T38.804T38.805T38.806
Hormone
  »androgenic
T38.801T38.802T38.803T38.804T38.805T38.806
Hormone
  »anterior pituitary NEC
T38.801T38.802T38.803T38.804T38.805T38.806
Hormone
  »antidiabetic agents
T38.801T38.802T38.803T38.804T38.805T38.806
Hormone
  »antidiuretic
T38.801T38.802T38.803T38.804T38.805T38.806
Hormone
  »cancer therapy
T38.801T38.802T38.803T38.804T38.805T38.806
Hormone
  »follicle stimulating
T38.801T38.802T38.803T38.804T38.805T38.806
Hormone
  »gonadotropic
T38.801T38.802T38.803T38.804T38.805T38.806
Hormone
  »gonadotropic
    »pituitary
T38.801T38.802T38.803T38.804T38.805T38.806
Hormone
  »growth
T38.801T38.802T38.803T38.804T38.805T38.806
Hormone
  »luteinizing
T38.801T38.802T38.803T38.804T38.805T38.806
Hormone
  »ovarian
T38.801T38.802T38.803T38.804T38.805T38.806
Hormone
  »oxytocic
T38.801T38.802T38.803T38.804T38.805T38.806
Hormone
  »parathyroid (derivatives)
T38.801T38.802T38.803T38.804T38.805T38.806
Hormone
  »pituitary (posterior) NEC
T38.801T38.802T38.803T38.804T38.805T38.806
Hormone
  »pituitary (posterior) NEC
    »anterior
T38.801T38.802T38.803T38.804T38.805T38.806
Hormone
  »specified, NEC
T38.801T38.802T38.803T38.804T38.805T38.806
Hormone
  »thyroid
T38.801T38.802T38.803T38.804T38.805T38.806

Patient Education


Hormones

Hormones are your body's chemical messengers. They travel in your bloodstream to tissues or organs. They work slowly, over time, and affect many different processes, including:

  • Growth and development
  • Metabolism - how your body gets energy from the foods you eat
  • Sexual function
  • Reproduction
  • Mood

Endocrine glands, which are special groups of cells, make hormones. The major endocrine glands are the pituitary, pineal, thymus, thyroid, adrenal glands, and pancreas. In addition, men produce hormones in their testes and women produce them in their ovaries.

Hormones are powerful. It takes only a tiny amount to cause big changes in cells or even your whole body. That is why too much or too little of a certain hormone can be serious. Laboratory tests can measure the hormone levels in your blood, urine, or saliva. Your health care provider may perform these tests if you have symptoms of a hormone disorder. Home pregnancy tests are similar - they test for pregnancy hormones in your urine.


[Learn More in MedlinePlus]

Poisoning

A poison is any substance that is harmful to your body. You might swallow it, inhale it, inject it, or absorb it through your skin. Any substance can be poisonous if too much is taken. Poisons can include:

  • Prescription or over-the-counter medicines taken in doses that are too high
  • Overdoses of illegal drugs
  • Carbon monoxide from gas appliances
  • Household products, such as laundry powder or furniture polish
  • Pesticides
  • Indoor or outdoor plants
  • Metals such as lead and mercury

The effects of poisoning range from short-term illness to brain damage, coma, and death. To prevent poisoning it is important to use and store products exactly as their labels say. Keep dangerous products where children can't get to them. Treatment for poisoning depends on the type of poison. If you suspect someone has been poisoned, call your local poison control center at 1-800-222-1222 right away.


[Learn More in MedlinePlus]

Code History

  • FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
  • FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
  • FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.