T38.803A — Poisoning by unspecified hormones and synthetic substitutes, assault, initial encounter
Is T38.803A billable?
Yes, but T38.803A is an unspecified code. T38.803A is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, T38.803A is an unspecified or catch-all code. Payers apply additional scrutiny to unspecified codes and many deny them when the medical record supports a more specific option, so check the documentation before selecting T38.803A.
T38.803A at a glance
| Code | T38.803A |
|---|---|
| Description | Poisoning by unspecified hormones and synthetic substitutes, assault, initial encounter |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "A" | initial encounter |
What does the 7th character "A" mean in T38.803A?
In T38.803A, the 7th character A means initial encounter. The 7th character is required for T38.803A to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
Which MS-DRGs does T38.803A group to?
T38.803A sits in MDC 21 and helps define the logic of 2 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 917Poisoning and Toxic Effects of Drugs with MCCmedical
- 918Poisoning and Toxic Effects of Drugs without MCCmedical
Excludes1 — never code together — inherited from T36-T50
The conditions below can never be reported together with T38.803A on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- toxic reaction to local anesthesia in pregnancy (O29.3-)
Excludes1 — never code together — inherited from T38
The conditions below can never be reported together with T38.803A on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
Code first — inherited from T36-T50
The underlying condition below must be sequenced before T38.803A. T38.803A describes a manifestation and cannot be the principal or first-listed diagnosis.
Use additional code — inherited from Chapter 19
Report an additional code alongside T38.803A to fully describe the condition. T38.803A is sequenced first.
- code to identify any retained foreign body, if applicable (Z18.-)
Use additional code — inherited from T36-T50
Report an additional code alongside T38.803A to fully describe the condition. T38.803A is sequenced first.
Excludes2 — not included here — inherited from Chapter 19
The conditions below are not part of T38.803A, but a patient may have both at the same time. When documentation supports it, T38.803A and the excluded code may both be reported.
Excludes2 — not included here — inherited from T36-T50
The conditions below are not part of T38.803A, but a patient may have both at the same time. When documentation supports it, T38.803A and the excluded code may both be reported.
How long has T38.803A existed?
T38.803A has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.