2024 ICD-10-CM Diagnosis Code T39.391A

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

• Accidental acemetacin overdose
• Accidental acemetacin poisoning
• Accidental diclofenac overdose
• Accidental diclofenac poisoning
• Accidental etodolac overdose
• Accidental etodolac poisoning
• Accidental felbinac overdose
• Accidental felbinac poisoning
• Accidental fenbufen overdose
• Accidental fenbufen poisoning
• Accidental indomethacin overdose
• Accidental mefenamic acid overdose
• Accidental mefenamic acid poisoning
• Accidental nabumetone overdose
• Accidental nabumetone poisoning
• Accidental overdose of non-steroidal anti-inflammatory agent
• Accidental piroxicam overdose
• Accidental piroxicam poisoning
• Accidental poisoning by indomethacin
• Accidental sulindac overdose
• Accidental sulindac poisoning
• Accidental tenoxicam overdose
• Accidental tenoxicam poisoning
• Accidental tolmetin overdose
• Accidental tolmetin poisoning
• Acemetacin overdose
• Acemetacin poisoning
• Diclofenac overdose
• Diclofenac poisoning
• Etodolac overdose
• Etodolac poisoning
• Felbinac overdose
• Felbinac poisoning
• Fenbufen overdose
• Fenbufen poisoning
• Flunixin poisoning
• Fungicide causing toxic effect
• Indomethacin overdose
• Mefenamic acid overdose
• Mefenamic acid poisoning
• Nabumetone overdose
• Nabumetone poisoning
• Non-steroidal anti-inflammatory overdose
• Piroxicam overdose
• Piroxicam poisoning
• Poisoning by indomethacin
• Sulindac overdose
• Sulindac poisoning
• Tenoxicam overdose
• Tenoxicam poisoning
• Tolmetin overdose
• Tolmetin poisoning

Clinical Information

• Diclofenac

  a non-steroidal anti-inflammatory agent (nsaid) with antipyretic and analgesic actions. it is primarily available as the sodium salt.

• Etodolac

  a non-steroidal anti-inflammatory agent and cyclooxygenase-2 (cox-2) inhibitor with potent analgesic and anti-arthritic properties. it has been shown to be effective in the treatment of osteoarthritis; rheumatoid arthritis; ankylosing spondylitis; and in the alleviation of postoperative pain (pain, postoperative).

• Flufenamic Acid

  an anthranilic acid derivative with analgesic, anti-inflammatory, and antipyretic properties. it is used in musculoskeletal and joint disorders and administered by mouth and topically. (from martindale, the extra pharmacopoeia, 30th ed, p16)

• Indomethacin

  a non-steroidal anti-inflammatory agent (nsaid) that inhibits cyclooxygenase, which is necessary for the formation of prostaglandins and other autacoids. it also inhibits the motility of polymorphonuclear leukocytes.

• Meclofenamic Acid

  a non-steroidal anti-inflammatory agent with antipyretic and antigranulation activities. it also inhibits prostaglandin biosynthesis.

• Mefenamic Acid

  a non-steroidal anti-inflammatory agent with analgesic, anti-inflammatory, and antipyretic properties. it is an inhibitor of cyclooxygenase.

• Nabumetone

  a butanone non-steroidal anti-inflammatory drug and cyclooxygenase-2 (cox2) inhibitor that is used in the management of pain associated with osteoarthritis and rheumatoid arthritis.

• Piroxicam

  a cyclooxygenase inhibiting, non-steroidal anti-inflammatory agent (nsaid) that is well established in treating rheumatoid arthritis and osteoarthritis and used for musculoskeletal disorders, dysmenorrhea, and postoperative pain. its long half-life enables it to be administered once daily.

• Sulindac

  a sulfinylindene derivative prodrug whose sulfinyl moiety is converted in vivo to an active nsaid analgesic. specifically, the prodrug is converted by liver enzymes to a sulfide which is excreted in the bile and then reabsorbed from the intestine. this helps to maintain constant blood levels with reduced gastrointestinal side effects.

• Tolmetin

  a non-steroidal anti-inflammatory agent (anti-inflammatory agents, non-steroidal) similar in mode of action to indomethacin.

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 nonopioid analgesics, antipyretics and antirheumatics (T39). Use the following options for the aplicable episode of care:

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

T39.391A is grouped with Diagnostic Related Groups - MS-DRG Mapping

Diagnostic Related Groups (DRGs) are a classification system used to group together diagnosis codes for the purpose of reimbursement and healthcare management. DRGs are used to standardize the way hospitals and other providers are paid for inpatient services. In this system patients are grouped together based on their principal diagnosis in areas referred to as Major Diagnostic Categories (MDC). Once a patient is assigned a particular diagnostic category, providers receive a predetermined payment rate for the services rendered. This reimbursement rate is often fixed and is meant to cover the cost of care for that patient. Reimbursement is also affected by the relative weight of a diagnostic related group based on the severity of a patient's illness and the associated cost of care during hospitalization.

Diagnostic related groups encourage healthcare providers to focus on quality and efficiency in patient care while managing costs effectively. The diagnosis code is present in the following groups for version MS-DRG V41.0 applicable from 10/01/2023 through 09/30/2024.

The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.

Convert T39.391A to ICD-9-CM

• ICD-9-CM Code: 965.61 - Pois-propionic acid derv
  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: E850.6 - Acc poison-antirheumatic
  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 T39.391 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.

Patient Education

Medication Errors

Medicines treat infectious diseases, prevent problems from chronic diseases, and ease pain. But medicines can also cause harmful reactions if not used correctly. Errors can happen in the hospital, at the health care provider's office, at the pharmacy, or at home. You can help prevent errors by:

• Knowing your medicines. When you get a prescription, ask the name of the medicine and check to make sure that the pharmacy gave you the right medicine. Make sure that you understand how often you should take the medicine and how long you should take it.
• Keeping a list of medicines.
• Write down all of the medicines that you are taking, including the names of your medicines, how much you take, and when you take them. Make sure to include any over-the-counter medicines, vitamins, supplements, and herbs that you take.
• List the medicines that you are allergic to or that have caused you problems in the past.
• Take this list with you every time you see a health care provider.
• Reading medicine labels and following the directions. Don't just rely on your memory - read the medication label every time. Be especially careful when giving medicines to children.
• Asking questions. If you don't know the answers to these questions, ask your health care provider or pharmacist:
• Why am I taking this medicine?
• What are the common side effects?
• What should I do if I have side effects?
• When should I stop this medicine?
• Can I take this medicine with the other medicines and supplements on my list?
• Do I need to avoid certain foods or alcohol while taking this medicine?

Food and Drug Administration

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.