ICDcodes.org
FY2027

T40.2X6AUnderdosing of other opioids, initial encounter

Billable

Is T40.2X6A billable?

Yes — T40.2X6A is billable for FY2027. T40.2X6A is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. T40.2X6A may be submitted for encounters from October 1, 2026 through September 30, 2027.

T40.2X6A at a glance

CodeT40.2X6A
DescriptionUnderdosing of other opioids, initial encounter
BillableYes
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027
7th character "A"initial encounter

What does the 7th character "A" mean in T40.2X6A?

In T40.2X6A, the 7th character A means initial encounter. The 7th character is required for T40.2X6A to be a valid, complete code.

Same condition, different episode of care — switch the 7th character:

What Medicare edits apply to T40.2X6A?

The Medicare Code Editor screens inpatient claims before they are grouped. These edits name T40.2X6A directly.

Cannot be a principal diagnosis — MCE edit 9

CMS will reject this code as the principal diagnosis on an inpatient claim. It describes something other than the condition chiefly responsible for the admission.

Which MS-DRGs does T40.2X6A group to?

T40.2X6A sits in MDC 23 and helps define the logic of 1 MS-DRG (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.

  • 951Other Factors Influencing Health Statusmedical

Excludes1 — never code together — inherited from T36-T50

The conditions below can never be reported together with T40.2X6A 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-)

Code first — inherited from T36-T50

The underlying condition below must be sequenced before T40.2X6A. T40.2X6A describes a manifestation and cannot be the principal or first-listed diagnosis.

  • , 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)

Use additional code — inherited from Chapter 19

Report an additional code alongside T40.2X6A to fully describe the condition. T40.2X6A 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 T40.2X6A to fully describe the condition. T40.2X6A is sequenced first.

  • 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-)

Excludes2 — not included here — inherited from Chapter 19

The conditions below are not part of T40.2X6A, but a patient may have both at the same time. When documentation supports it, T40.2X6A and the excluded code may both be reported.

  • birth trauma (P10-P15)
  • obstetric trauma (O70-O71)

Excludes2 — not included here — inherited from T36-T50

The conditions below are not part of T40.2X6A, but a patient may have both at the same time. When documentation supports it, T40.2X6A and the excluded code may both be reported.

  • 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)

Excludes2 — not included here — inherited from T40

The conditions below are not part of T40.2X6A, but a patient may have both at the same time. When documentation supports it, T40.2X6A and the excluded code may both be reported.

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

How long has T40.2X6A existed?

T40.2X6A 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.