Poisoning by and adverse effect of heroin

Not billableICD-10-CM diagnosis code.

This code exists but cannot be submitted on its own. It groups the more specific codes beneath it.

A category header for its whole life, FY2016 onwards. It has never been valid for submission on its own.

Submit one of these 4 more specific codes instead:

T40.1X1 Poisoning by heroin, accidental (unintentional) (also a header)
T40.1X2 Poisoning by heroin, intentional self-harm (also a header)
T40.1X3 Poisoning by heroin, assault (also a header)
T40.1X4 Poisoning by heroin, undetermined (also a header)

This code requires a seventh character. See the rule below.

What has happened to this code

Every change the publisher made, from 2012 to now. Entries marked draft are from the pre-implementation releases: ICD-10 took effect on 1 October 2015, so nothing before FY2016 was ever valid on a claim.

FY2012 Added to the draft code set draft Poisoning by and adverse effect of heroin

Official coding rules

Published by CDC for FY2027. A rule attached to a category binds every code beneath it, so the rules inherited from this code's ancestors are shown with the code they come from.

Inherited from T40 Poisoning by, adverse effect of and underdosing of narcotics and psychodysleptics [hallucinogens]

Seventh character required

The appropriate 7th character is to be added to each code from category T40

Excludes2 - not included here

drug dependence and related mental and behavioral disorders due to psychoactive substance use (F10.-F19.-)

Inherited from the T36-T50 section Poisoning by, adverse effects of and underdosing of drugs, medicaments and biological substances (T36-T50)

Excludes1 - never coded here

toxic reaction to local anesthesia in pregnancy (O29.3-)

Excludes2 - not included here

abuse and dependence of psychoactive substances (F10-F19)
abuse of non-dependence-producing substances (F55.-)
immunodeficiency due to drugs (D84.821)
drug reaction and poisoning affecting newborn (P00-P96)
pathological drug intoxication (inebriation) (F10-F19)

Use additional code

code(s) to specify:
manifestations of poisoning
underdosing or failure in dosage during medical and surgical care (Y63.6, Y63.8-Y63.9)
underdosing of medication regimen (Z91.12-, Z91.13-)

Code first

, for adverse effects, the nature of the adverse effect, such as:
adverse effect NOS (T88.7)
aspirin gastritis (K29.-)
blood disorders (D56-D76)
contact dermatitis (L23-L25)
dermatitis due to substances taken internally (L27.-)
nephropathy (N14.0-N14.2)

Includes

adverse effect of correct substance properly administered
poisoning by overdose of substance
poisoning by wrong substance given or taken in error
underdosing by (inadvertently) (deliberately) taking less substance than prescribed or instructed

Note

The drug giving rise to the adverse effect should be identified by use of codes from categories T36-T50 with fifth or sixth character 5.