2024 ICD-10-CM Diagnosis Code T42.4X1

Specific Coding Applicable to Poisoning by benzodiazepines, accidental (unintentional)

Non-specific codes like T42.4X1 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10-CM codes with a higher level of specificity when coding for poisoning by benzodiazepines, accidental (unintentional):

Approximate Synonyms

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

• Accidental alprazolam overdose
• Accidental alprazolam poisoning
• Accidental bromazepam overdose
• Accidental bromazepam poisoning
• Accidental chlordiazepoxide overdose
• Accidental clobazam overdose
• Accidental clobazam poisoning
• Accidental clonazepam overdose
• Accidental clonazepam poisoning
• Accidental clorazepate overdose
• Accidental clorazepate poisoning
• Accidental clozapine overdose
• Accidental clozapine poisoning
• Accidental diazepam overdose
• Accidental flunitrazepam overdose
• Accidental flunitrazepam poisoning
• Accidental flurazepam overdose
• Accidental ketazolam overdose
• Accidental ketazolam poisoning
• Accidental loprazolam overdose
• Accidental loprazolam poisoning
• Accidental lorazepam overdose
• Accidental lormetazepam overdose
• Accidental lormetazepam poisoning
• Accidental medazepam overdose
• Accidental midazolam overdose
• Accidental midazolam poisoning
• Accidental nitrazepam overdose
• Accidental overdose by temazepam
• Accidental overdose of benzodiazepine
• Accidental oxazepam overdose
• Accidental oxazepam poisoning
• Accidental poisoning by benzodiazepine-based tranquilizer
• Accidental poisoning by chlordiazepoxide
• Accidental poisoning by diazepam
• Accidental poisoning by flurazepam
• Accidental poisoning by lorazepam
• Accidental poisoning by medazepam
• Accidental poisoning by nitrazepam
• Accidental poisoning by temazepam
• Accidental prazepam overdose
• Accidental prazepam poisoning
• Accidental triazolam overdose
• Accidental triazolam poisoning
• Alprazolam overdose
• Alprazolam poisoning
• Bromazepam overdose
• Bromazepam poisoning
• Chlordiazepoxide overdose
• Clobazam overdose
• Clobazam poisoning
• Clonazepam overdose
• Clonazepam poisoning
• Clorazepate overdose
• Clorazepate poisoning
• Clozapine overdose
• Clozapine poisoning
• Diazepam overdose
• Flunitrazepam overdose
• Flunitrazepam poisoning
• Flurazepam overdose
• Ketazolam overdose
• Ketazolam poisoning
• Loprazolam overdose
• Loprazolam poisoning
• Lorazepam overdose
• Lormetazepam overdose
• Lormetazepam poisoning
• Medazepam overdose
• Midazolam overdose
• Midazolam poisoning
• Nitrazepam overdose
• Overdose of temazepam
• Oxazepam overdose
• Oxazepam poisoning
• Poisoning by benzodiazepine-based tranquilizer
• Poisoning by chlordiazepoxide
• Poisoning by diazepam
• Poisoning by flurazepam
• Poisoning by lorazepam
• Poisoning by medazepam
• Poisoning by nitrazepam
• Poisoning by temazepam
• Prazepam overdose
• Prazepam poisoning
• Triazolam overdose
• Triazolam poisoning

Clinical Information

• Alprazolam

  a triazolobenzodiazepine compound with antianxiety and sedative-hypnotic actions, that is efficacious in the treatment of panic disorders, with or without agoraphobia, and in generalized anxiety disorders. (from ama drug evaluations annual, 1994, p238)

• Bromazepam

  one of the benzodiazepines that is used in the treatment of anxiety disorders.

• Chlordiazepoxide

  an anxiolytic benzodiazepine derivative with anticonvulsant, sedative, and amnesic properties. it has also been used in the symptomatic treatment of alcohol withdrawal.

• Clobazam

  a benzodiazepine derivative that is a long-acting gaba-a receptor agonist. it is used as an antiepileptic in the treatment of seizures, including seizures associated with lennox-gastaut syndrome. it is also used as an anxiolytic, for the short-term treatment of acute anxiety.

• Clonazepam

  an anticonvulsant used for several types of seizures, including myotonic or atonic seizures, photosensitive epilepsy, and absence seizures, although tolerance may develop. it is seldom effective in generalized tonic-clonic or partial seizures. the mechanism of action appears to involve the enhancement of gamma-aminobutyric acid receptor responses.

• Clozapine

  a tricylic dibenzodiazepine, classified as an atypical antipsychotic agent. it binds several types of central nervous system receptors, and displays a unique pharmacological profile. clozapine is a serotonin antagonist, with strong binding to 5-ht 2a/2c receptor subtype. it also displays strong affinity to several dopaminergic receptors, but shows only weak antagonism at the dopamine d2 receptor, a receptor commonly thought to modulate neuroleptic activity. agranulocytosis is a major adverse effect associated with administration of this agent.

• Diazepam

  a benzodiazepine with anticonvulsant, anxiolytic, sedative, muscle relaxant, and amnesic properties and a long duration of action. its actions are mediated by enhancement of gamma-aminobutyric acid activity.

• Diazepam Binding Inhibitor

  an 86-amino acid polypeptide, found in central and peripheral tissues, that displaces diazepam from the benzodiazepine recognition site on the gamma-aminobutyric acid receptor (receptors, gaba). it also binds medium- and long-chain acyl-coa esters and serves as an acyl-coa transporter. this peptide regulates lipid metabolism.

• Receptors, GABA-A

  cell surface proteins which bind gamma-aminobutyric acid and contain an integral membrane chloride channel. each receptor is assembled as a pentamer from a pool of at least 19 different possible subunits. the receptors belong to a superfamily that share a common cysteine loop.

• Estazolam

  a benzodiazepine with anticonvulsant, hypnotic, and muscle relaxant properties. it has been shown in some cases to be more potent than diazepam or nitrazepam.

• Flunitrazepam

  a benzodiazepine with pharmacologic actions similar to those of diazepam that can cause anterograde amnesia. some reports indicate that it is used as a date rape drug and suggest that it may precipitate violent behavior. the united states government has banned the importation of this drug.

• Flurazepam

  a benzodiazepine derivative used mainly as a hypnotic.

• Lorazepam

  a benzodiazepine used as an anti-anxiety agent with few side effects. it also has hypnotic, anticonvulsant, and considerable sedative properties and has been proposed as a preanesthetic agent.

• Medazepam

  a benzodiazepine derivative used in the treatment of anxiety. it has sedative, muscle relaxant, and anticonvulsant properties. one of its metabolites is diazepam and one of its excretion products is oxazepam.

• Midazolam

  a short-acting hypnotic-sedative drug with anxiolytic and amnestic properties. it is used in dentistry, cardiac surgery, endoscopic procedures, as preanesthetic medication, and as an adjunct to local anesthesia. the short duration and cardiorespiratory stability makes it useful in poor-risk, elderly, and cardiac patients. it is water-soluble at ph less than 4 and lipid-soluble at physiological ph.

• Nitrazepam

  a benzodiazepine derivative used as an anticonvulsant and hypnotic.

• Nordazepam

  an intermediate in the metabolism of diazepam to oxazepam. it may have actions similar to those of diazepam.

• Oxazepam

  a benzodiazepine used in the treatment of anxiety, alcohol withdrawal, and insomnia.

• Prazepam

  a benzodiazepine that is used in the treatment of anxiety disorders.

• Temazepam

  a benzodiazepine that acts as a gamma-aminobutyric acid modulator and anti-anxiety agent.

• Triazolam

  a short-acting benzodiazepine used in the treatment of insomnia. some countries temporarily withdrew triazolam from the market because of concerns about adverse reactions, mostly psychological, associated with higher dose ranges. its use at lower doses with appropriate care and labeling has been reaffirmed by the fda and most other countries.

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 antiepileptic, sedative- hypnotic and antiparkinsonism drugs (T42). Use the following options for the aplicable episode of care:

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

Table of Drugs and Chemicals

The 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.