2025 ICD-10-CM Diagnosis Code T46.5X2S

Poisoning by other antihypertensive drugs, intentional self-harm, sequela

ICD-10-CM Code:
T46.5X2S
ICD-10 Code for:
Poisoning by oth antihypertensive drugs, self-harm, sequela
Is Billable?
Yes - Valid for Submission
Chronic Condition Indicator: [1]
Not chronic
Code Navigator:

T46.5X2S is a billable diagnosis code used to specify a medical diagnosis of poisoning by other antihypertensive drugs, intentional self-harm, sequela. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2024 through September 30, 2025. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

T46.5X2S is a sequela code, includes a 7th character and should be used for complications that arise as a direct result of a condition like poisoning by other antihypertensive drugs intentional self-harm. According to ICD-10-CM Guidelines a "sequela" code should be used for chronic or residual conditions that are complications of an initial acute disease, illness or injury. The most common sequela is pain. Usually, two diagnosis codes are needed when reporting sequela. The first code describes the nature of the sequela while the second code describes the sequela or late effect.

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 agents primarily affecting the cardiovascular system
        T46

Approximate Synonyms

The following list of clinical terms are approximate synonyms, alternative descriptions, or common phrases that might be used by patients, healthcare providers, or medical coders to describe the same condition. These synonyms and related diagnosis terms are often used when searching for an ICD-10 code, especially when the exact medical terminology is unclear. Whether you're looking for lay terms, similar diagnosis names, or common language alternatives, this list can help guide you to the correct ICD-10 classification.

  • Adrenergic neurone blocking drug overdose
  • Adrenergic neurone blocking drug poisoning
  • Adrenergic neurone blocking drug poisoning
  • Alpha-adrenoceptor agonist overdose
  • Central alpha-2 adrenergic receptor agonist overdose
  • Central alpha-2 adrenergic receptor agonist poisoning
  • Central alpha-2 adrenergic receptor agonist poisoning
  • Clonidine overdose
  • Diazoxide overdose
  • Guanethidine overdose
  • Hydralazine overdose
  • Hydralazine poisoning
  • Hydralazine poisoning
  • Intentional antihypertensive overdose
  • Intentional clonidine overdose
  • Intentional clonidine poisoning
  • Intentional diazoxide overdose
  • Intentional diazoxide poisoning
  • Intentional guanethidine overdose
  • Intentional guanethidine poisoning
  • Intentional hydralazine overdose
  • Intentional hydralazine poisoning
  • Poisoning by clonidine
  • Poisoning by clonidine
  • Poisoning by diazoxide
  • Poisoning by diazoxide
  • Poisoning by guanethidine
  • Poisoning by guanethidine

Clinical Classification

Clinical Classifications group individual ICD-10-CM diagnosis codes into broader, clinically meaningful categories. These categories help simplify complex data by organizing related conditions under common clinical themes.

They are especially useful for data analysis, reporting, and clinical decision-making. Even when diagnosis codes differ, similar conditions can be grouped together based on their clinical relevance. Each category is assigned a unique CCSR code that represents a specific clinical concept, often tied to a body system or medical specialty.

Mental and substance use disorders; sequela

CCSR Code: MBD034

Inpatient Default: Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.

Outpatient Default: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.

Poisoning/toxic effect/adverse effects/underdosing, sequela

CCSR Code: INJ075

Inpatient Default: N - Not default inpatient assignment for principal diagnosis or first-listed diagnosis.

Outpatient Default: N - Not default outpatient assignment for principal diagnosis or first-listed diagnosis.

Clinical Information

  • Bethanidine

    a guanidinium antihypertensive agent that acts by blocking adrenergic transmission. the precise mode of action is not clear.
  • Clonidine

    an imidazoline sympatholytic agent that stimulates alpha-2 adrenergic receptors and central imidazoline receptors. it is commonly used in the management of hypertension.
  • Diazoxide

    a benzothiadiazine derivative that is a peripheral vasodilator used for hypertensive emergencies. it lacks diuretic effect, apparently because it lacks a sulfonamide group.
  • Dihydralazine

    1,4-dihydrazinophthalazine. an antihypertensive agent with actions and uses similar to those of hydralazine. (from martindale, the extra pharmacopoeia, 30th ed, p354)
  • Dihydroergotamine

    a 9,10alpha-dihydro derivative of ergotamine. it is used as a vasoconstrictor, specifically for the therapy of migraine disorders.
  • Ergotamine

    a vasoconstrictor found in ergot of central europe. it is a serotonin agonist that has been used as an oxytocic agent and in the treatment of migraine disorders.
  • Ergotamines

    a series of structurally-related alkaloids containing the ergotaman backbone structure.
  • Guanabenz

    an alpha-2 selective adrenergic agonist used as an antihypertensive agent.
  • Guanethidine

    an antihypertensive agent that acts by inhibiting selectively transmission in post-ganglionic adrenergic nerves. it is believed to act mainly by preventing the release of norepinephrine at nerve endings and causes depletion of norepinephrine in peripheral sympathetic nerve terminals as well as in tissues.
  • Guanfacine

    a centrally acting antihypertensive agent with specificity towards adrenergic alpha-2 receptors.
  • Hydralazine

    a direct-acting vasodilator that is used as an antihypertensive agent.
  • Indapamide

    a benzamide-sulfonamide-indole derived diuretic that functions by inhibiting sodium chloride symporters.
  • Carbidopa

    an inhibitor of dopa decarboxylase that prevents conversion of levodopa to dopamine. it is used in parkinson disease to reduce peripheral adverse effects of levodopa. it has no anti-parkinson activity by itself.
  • Deoxyepinephrine

    sympathomimetic, vasoconstrictor agent.
  • Methyldopa

    an alpha-2 adrenergic agonist that has both central and peripheral nervous system effects. its primary clinical use is as an antihypertensive agent.
  • Methysergide

    an ergot derivative that is a congener of lysergic acid diethylamide. it antagonizes the effects of serotonin in blood vessels and gastrointestinal smooth muscle, but has few of the properties of other ergot alkaloids. methysergide is used prophylactically in migraine and other vascular headaches and to antagonize serotonin in the carcinoid syndrome.
  • Nitroprusside

    a powerful vasodilator used in emergencies to lower blood pressure or to improve cardiac function. it is also an indicator for free sulfhydryl groups in proteins.
  • Pargyline

    a monoamine oxidase inhibitor with antihypertensive properties.
  • Pinacidil

    a guanidine that opens potassium channels producing direct peripheral vasodilatation of the arterioles. it reduces blood pressure and peripheral resistance and produces fluid retention. (martindale the extra pharmacopoeia, 31st ed)
  • Saralasin

    an octapeptide analog of angiotensin ii (bovine) with amino acids 1 and 8 replaced with sarcosine and alanine, respectively. it is a highly specific competitive inhibitor of angiotensin ii that is used in the diagnosis of hypertension.
  • Teprotide

    a synthetic nonapeptide (pyr-trp-pro-arg-pro-gln-ile-pro-pro) which is identical to the peptide from the venom of the snake, bothrops jararaca. it inhibits kininase ii and angiotensin i and has been proposed as an antihypertensive agent.
  • Todralazine

    an antihypertensive agent with both central and peripheral action; it has some central nervous system depressant effects.
  • Veratrine

    a voltage-gated sodium channel activator.

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 agents primarily affecting the cardiovascular system (T46). Use the following options for the aplicable episode of care:

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

Present on Admission (POA)

T46.5X2S is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here.

CMS POA Indicator Options and Definitions

POA Indicator: Y

Reason: Diagnosis was present at time of inpatient admission.

CMS Pays CC/MCC DRG? YES

POA Indicator: N

Reason: Diagnosis was not present at time of inpatient admission.

CMS Pays CC/MCC DRG? NO

POA Indicator: U

Reason: Documentation insufficient to determine if the condition was present at the time of inpatient admission.

CMS Pays CC/MCC DRG? NO

POA Indicator: W

Reason: Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.

CMS Pays CC/MCC DRG? YES

POA Indicator: 1

Reason: Unreported/Not used - Exempt from POA reporting.

CMS Pays CC/MCC DRG? NO

Convert T46.5X2S to ICD-9-CM

Below are the ICD-9 codes that most closely match this ICD-10 code, based on the General Equivalence Mappings (GEMs). This ICD-10 to ICD-9 crosswalk tool is helpful for coders who need to reference legacy diagnosis codes for audits, historical claims, or approximate code comparisons.

Late eff drug poisoning

ICD-9-CM: 909.0

Approximate Flag - The approximate mapping means this ICD-10 code does not have an exact ICD-9 equivalent. The matched code is the closest available option, but it may not fully capture the original diagnosis or clinical intent.

Late eff of self-injury

ICD-9-CM: E959

Approximate Flag - The approximate mapping means this ICD-10 code does not have an exact ICD-9 equivalent. The matched code is the closest available option, but it may not fully capture the original diagnosis or clinical intent.

Table of Drugs and Chemicals

The parent code T46.5X2 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
AldometT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
AlkavervirT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
AlseroxylonT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
AmiquinsinT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
Antihypertensive drug NECT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
ApresolineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
Benzapril hydrochlorideT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
BetanidineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
BethanidineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
BudralazineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
CadralazineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
ClonidineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
Cryptenamine (tannates)T46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
DebrisoquineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
DeserpidineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
DiazoxideT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
DihydralazineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
DihydrazineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
DihydroergotamineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
EndralazineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
ErgotamineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
GuanabenzT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
GuanaclineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
GuanadrelT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
GuanethidineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
GuanfacineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
GuanochlorT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
GuanoclorT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
GuanoctineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
GuanoxabenzT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
GuanoxanT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
HarmonylT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
HydralazineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
Hypotensive NECT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
IndapamideT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
LacidipineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
MethoserpidineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
MethyldopaT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
MethyldopateT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
MethysergideT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
MetirosineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
ModerilT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
NitroprussideT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
PargylineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
PinacidilT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
Protoveratrine (s) (A) (B)T46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
RaudixinT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
RautensinT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
RautinaT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
RautotalT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
RauwiloidT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
RauwoldinT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
Rauwolfia (alkaloids)T46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
RescinnamineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
Reserpin (e)T46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
SandrilT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
SaralasinT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
SerpasilT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
SingoserpT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
SyrosingopineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
TeprotideT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
TodralazineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
TolonidineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
UrapidilT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
VeratrineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6

Patient Education


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]

Self-Harm

What is self-harm?

Self-harm, or self-injury, is when a person hurts his or her own body on purpose. The injuries may be minor, but sometimes they can be severe. They may leave permanent scars or cause serious health problems. Some examples are:

  • Cutting yourself (such as using a razor blade, knife, or other sharp object to cut your skin)
  • Punching yourself or punching things (like a wall)
  • Burning yourself with cigarettes, matches, or candles
  • Pulling out your hair
  • Poking objects through body openings
  • Breaking your bones or bruising yourself

Self-harm is not a mental disorder. It is a behavior - an unhealthy way to cope with strong feelings. However, some of the people who harm themselves do have a mental disorder.

People who harm themselves are usually not trying to attempt suicide. But they are at higher risk of attempting suicide if they do not get help.

Why do people harm themselves?

There are different reasons why people harm themselves. Often, they have trouble coping and dealing with their feelings. They harm themselves to try to:

  • Make themselves feel something (because they feel empty or numb inside)
  • Block upsetting memories
  • Show that they need help
  • Release strong feelings that overwhelm them, such as anger, loneliness, or hopelessness
  • Punish themselves
  • Feel a sense of control

Who is at risk for self-harm?

There are people of all ages who harm themselves, but it usually starts in the teen or early adult years. Self-harm is more common in people who:

  • Were abused or went through a trauma as children
  • Have mental disorders, such as
    • Depression
    • Eating disorders
    • Post-traumatic stress disorder
    • Certain personality disorders
  • Misuse drugs or alcohol
  • Have friends who self-harm
  • Have low self-esteem

What are the signs of self-harm?

Signs that someone may be hurting themselves include:

  • Having frequent cuts, bruises, or scars
  • Wearing long sleeves or pants even in hot weather
  • Making excuses about injuries
  • Having sharp objects around for no clear reason

How can I help someone who self-harms?

If someone you know is self-harming, it is important not to be judgmental. Let that person know that you want to help. If the person is a child or teenager, ask him or her to talk to a trusted adult. If he or she won't do that, talk to a trusted adult yourself. If the person who is self-harming is an adult, suggest mental health counseling.

What the treatments are for self-harm?

There are no medicines to treat self-harming behaviors. But there are medicines to treat any mental disorders that the person may have, such as anxiety and depression. Treating the mental disorder may weaken the urge to self-harm.

Mental health counseling or therapy can also help by teaching the person:

  • Problem-solving skills
  • New ways to cope with strong emotions
  • Better relationship skills
  • Ways to strengthen self-esteem

If the problem is severe, the person may need more intensive treatment in a psychiatric hospital or a mental health day program.


[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.