2024 ICD-10-CM Diagnosis Code T45.7X1

Specific Coding Applicable to Poisoning by anticoag antag, vitamin K and oth coag, acc

Non-specific codes like T45.7X1 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 anticoag antag, vitamin k and oth coag, acc:

Approximate Synonyms

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

• Accidental protamine overdose
• Accidental protamine poisoning
• Accidental vitamin K and/or vitamin K derivative overdose
• Accidental vitamin K poisoning
• Antidote overdose
• Antidote overdose
• Poisoning by coagulant
• Poisoning by hexadimethrine
• Poisoning by vitamin K
• Poisoning caused by protamine
• Protamine overdose
• Vitamin K and/or vitamin K derivative overdose

Clinical Information

• Ethamsylate

  benzenesulfonate derivative used as a systemic hemostatic.

• Hypoprothrombinemias

  absence or reduced levels of prothrombin in the blood.

• Prothrombin

  a plasma protein that is the inactive precursor of thrombin. it is converted to thrombin by a prothrombin activator complex consisting of factor xa, factor v, phospholipid, and calcium ions. deficiency of prothrombin leads to hypoprothrombinemia.

• Prothrombin Time

  clotting time of plasma recalcified in the presence of excess tissue thromboplastin. factors measured are fibrinogen; prothrombin; factor v; factor vii; and factor x. it is used for monitoring anticoagulant therapy with coumarins.

• Thromboplastin

  constituent composed of protein and phospholipid that is widely distributed in many tissues. it serves as a cofactor with factor viia to activate factor x in the extrinsic pathway of blood coagulation.

• Anticoagulants

  agents that prevent blood clotting.

• Antithrombins

  endogenous factors and drugs that directly inhibit the action of thrombin, usually by blocking its enzymatic activity. they are distinguished from indirect thrombin inhibitors, such as heparin, which act by enhancing the inhibitory effects of antithrombins.

• Carboxypeptidase B2

  a carboxypeptidase that removes c-terminal lysine or arginine from peptides and proteins. carboxypeptidase b2 (cpb2) is released into the circulation as a proenzyme which is activated by the thrombin-thrombomodulin complex. activated cpb2 is involved in modulating a variety of processes by cleaving and inactivating various circulating proteins and peptides that are its substrates including fibrin; kinins; and anaphylatoxins.

• Factor VIIIa

  activated form of factor viii. the b-domain of factor viii is proteolytically cleaved by thrombin to form factor viiia. factor viiia exists as a non-covalent dimer in a metal-linked (probably calcium) complex and functions as a cofactor in the enzymatic activation of factor x by factor ixa. factor viiia is similar in structure and generation to factor va.

• Receptors, Thrombin

  a family of proteinase-activated receptors that are specific for thrombin. they are found primarily on platelets and on endothelial cells. activation of thrombin receptors occurs through the proteolytic action of thrombin, which cleaves the n-terminal peptide from the receptor to reveal a new n-terminal peptide that is a cryptic ligand for the receptor. the receptors signal through heterotrimeric gtp-binding proteins. small synthetic peptides that contain the unmasked n-terminal peptide sequence can also activate the receptor in the absence of proteolytic activity.

• Thrombin

  an enzyme formed from prothrombin that converts fibrinogen to fibrin.

• Thrombin Time

  clotting time of plasma mixed with a thrombin solution. it is a measure of the conversion of fibrinogen to fibrin, which is prolonged by afibrinogenemia, abnormal fibrinogen, or the presence of inhibitory substances, e.g., fibrin-fibrinogen degradation products, or heparin. batroxobin, a thrombin-like enzyme unaffected by the presence of heparin, may be used in place of thrombin.

• Factor VIII

  factor viii of blood coagulation. antihemophilic factor that is part of the factor viii/von willebrand factor complex. factor viii is produced in the liver and acts in the intrinsic pathway of blood coagulation. it serves as a cofactor in factor x activation and this action is markedly enhanced by small amounts of thrombin.

• Factor XI

  stable blood coagulation factor involved in the intrinsic pathway. the activated form xia activates factor ix to ixa. deficiency of factor xi is often called hemophilia c.

• Partial Thromboplastin Time

  the time required for the appearance of fibrin strands following the mixing of plasma with phospholipid platelet substitute (e.g., crude cephalins, soybean phosphatides). it is a test of the intrinsic pathway (factors viii, ix, xi, and xii) and the common pathway (fibrinogen, prothrombin, factors v and x) of blood coagulation. it is used as a screening test and to monitor heparin therapy.

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 primarily systemic and hematological agents, not elsewhere classified (T45). 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.