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Substance Poisoning
Accidental (unintentional)
Poisoning
Intentional (self-harm)
Poisoning
Assault
Poisoning
Undetermined
Adverse
Effect
Underdosing
5-Deoxy-5-fluorouridine T45.1X1 T45.1X2 T45.1X3 T45.1X4 T45.1X5 T45.1X6
Deoxyribonuclease (pancreatic) T45.3X1 T45.3X2 T45.3X3 T45.3X4 T45.3X5 T45.3X6
Depilatory T49.4X1 T49.4X2 T49.4X3 T49.4X4 T49.4X5 T49.4X6
Deprenalin T42.8X1 T42.8X2 T42.8X3 T42.8X4 T42.8X5 T42.8X6
Deprenyl T42.8X1 T42.8X2 T42.8X3 T42.8X4 T42.8X5 T42.8X6
Depressant, appetite T50.5X1 T50.5X2 T50.5X3 T50.5X4 T50.5X5 T50.5X6
Depressant
– appetite (central) T50.5X1 T50.5X2 T50.5X3 T50.5X4 T50.5X5 T50.5X6
– cardiac T46.2X1 T46.2X2 T46.2X3 T46.2X4 T46.2X5 T46.2X6
– central nervous system (anesthetic)   see also Central nervous system, depressants T42.71 T42.72 T42.73 T42.74 T42.75 T42.76
– – general anesthetic T41.201 T41.202 T41.203 T41.204 T41.205 T41.206
– – muscle tone T42.8X1 T42.8X2 T42.8X3 T42.8X4 T42.8X5 T42.8X6
– muscle tone, central T42.8X1 T42.8X2 T42.8X3 T42.8X4 T42.8X5 T42.8X6
– psychotherapeutic T43.501 T43.502 T43.503 T43.504 T43.505 T43.506
Deptropine T45.0X1 T45.0X2 T45.0X3 T45.0X4 T45.0X5 T45.0X6
Dequalinium (chloride) T49.0X1 T49.0X2 T49.0X3 T49.0X4 T49.0X5 T49.0X6
Derris root T60.2X1 T60.2X2 T60.2X3 T60.2X4 -- --

The occurrence of drug toxicity is classified in ICD-10-CM as follows:

Adverse Effect

When coding an adverse effect of a drug that has been correctly prescribed and properly administered, assign the appropriate code for the nature of the adverse effect followed by the appropriate code for the adverse effect of the drug (T36-T50). The code for the drug should have a 5th or 6th character “5” (for example T36.0X5-) Examples of the nature of an adverse effect are tachycardia, delirium, gastrointestinal hemorrhaging, vomiting, hypokalemia, hepatitis, renal failure, or respiratory failure.

Poisoning

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.

If there is also a diagnosis of abuse or dependence of the substance, the abuse or dependence is assigned as an additional code.

Examples of poisoning include:
  • Error was made in drug prescription
    Errors made in drug prescription or in the administration of the drug by provider, nurse, patient, or other person.
  • Overdose of a drug intentionally taken
    If an overdose of a drug was intentionally taken or administered and resulted in drug toxicity, it would be coded as a poisoning.
  • Nonprescribed drug taken with correctly prescribed and properly administered drug
    If a nonprescribed drug or medicinal agent was taken in combination with a correctly prescribed and properly administered drug, any drug toxicity or other reaction resulting from the interaction of the two drugs would be classified as a poisoning.
  • Interaction of drug(s) and alcohol
    When a reaction results from the interaction of a drug(s) and alcohol, this would be classified as poisoning.
Underdosing

Underdosing refers to taking less of a medication than is prescribed by a provider or a manufacturer's instruction. Discontinuing the use of a prescribed medication on the patient's own initiative (not directed by the patient's provider) is also classified as an underdosing. For underdosing, assign the code from categories T36-T50 (fifth or sixth character “6”).

Codes for underdosing should never be assigned as principal or first-listed codes. If a patient has a relapse or exacerbation of the medical condition for which the drug is prescribed because of the reduction in dose, then the medical condition itself should be coded.

Noncompliance (Z91.12-, Z91.13- and Z91.14-) or complication of care (Y63.6-Y63.9) codes are to be used with an underdosing code to indicate intent, if known.

Toxic Effects

When a harmful substance is ingested or comes in contact with a person, this is classified as a toxic effect. The toxic effect codes are in categories T51-T65.

Toxic effect codes have an associated intent: accidental, intentional self-harm, assault and undetermined.