T40.42 — Poisoning by, adverse effect of and underdosing of tramadol
Is T40.42 billable?
No — T40.42 is a non-billable header code. T40.42 groups more specific codes and cannot be submitted on a claim. A valid ICD-10-CM code must be reported at the highest level of specificity available in its branch. Select one of the 18 billable codes beneath T40.42.
Billable codes under this header
- T40.421APoisoning by tramadol, accidental (unintentional), initial encounter
- T40.421DPoisoning by tramadol, accidental (unintentional), subsequent encounter
- T40.421SPoisoning by tramadol, accidental (unintentional), sequela
- T40.422APoisoning by tramadol, intentional self-harm, initial encounter
- T40.422DPoisoning by tramadol, intentional self-harm, subsequent encounter
- T40.422SPoisoning by tramadol, intentional self-harm, sequela
- T40.423APoisoning by tramadol, assault, initial encounter
- T40.423DPoisoning by tramadol, assault, subsequent encounter
- T40.423SPoisoning by tramadol, assault, sequela
- T40.424APoisoning by tramadol, undetermined, initial encounter
- T40.424DPoisoning by tramadol, undetermined, subsequent encounter
- T40.424SPoisoning by tramadol, undetermined, sequela
- T40.425AAdverse effect of tramadol, initial encounter
- T40.425DAdverse effect of tramadol, subsequent encounter
- T40.425SAdverse effect of tramadol, sequela
- T40.426AUnderdosing of tramadol, initial encounter
- T40.426DUnderdosing of tramadol, subsequent encounter
- T40.426SUnderdosing of tramadol, sequela
T40.42 at a glance
| Code | T40.42 |
|---|---|
| Description | Poisoning by, adverse effect of and underdosing of tramadol |
| Billable | No — header code |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Excludes1 — never code together — inherited from T36-T50
The conditions below can never be reported together with T40.42 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 T40.42. T40.42 describes a manifestation and cannot be the principal or first-listed diagnosis.
Use additional code — inherited from Chapter 19
Report an additional code alongside T40.42 to fully describe the condition. T40.42 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 T40.42 to fully describe the condition. T40.42 is sequenced first.
Excludes2 — not included here — inherited from Chapter 19
The conditions below are not part of T40.42, but a patient may have both at the same time. When documentation supports it, T40.42 and the excluded code may both be reported.
Excludes2 — not included here — inherited from T36-T50
The conditions below are not part of T40.42, but a patient may have both at the same time. When documentation supports it, T40.42 and the excluded code may both be reported.
Excludes2 — not included here — inherited from T40
The conditions below are not part of T40.42, but a patient may have both at the same time. When documentation supports it, T40.42 and the excluded code may both be reported.
- drug dependence and related mental and behavioral disorders due to psychoactive substance use (F10.-F19.-)
What codes fall under T40.42? (6)
- T40.421Poisoning by tramadol, accidental (unintentional)not billable
- T40.422Poisoning by tramadol, intentional self-harmnot billable
- T40.423Poisoning by tramadol, assaultnot billable
- T40.424Poisoning by tramadol, undeterminednot billable
- T40.425Adverse effect of tramadolnot billable
- T40.426Underdosing of tramadolnot billable
How long has T40.42 existed?
T40.42 first appears in FY2021 (FY2020 is not available, so it may have appeared then).
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.