T56.94XS — Toxic effect of unspecified metal, undetermined, sequela
Is T56.94XS billable?
Yes, but T56.94XS is an unspecified code. T56.94XS is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, T56.94XS 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 T56.94XS — the more specific alternatives are listed below.
More specific alternatives
- T56.0X1SToxic effect of lead and its compounds, accidental (unintentional), sequela
- T56.1X1SToxic effect of mercury and its compounds, accidental (unintentional), sequela
- T56.2X1SToxic effect of chromium and its compounds, accidental (unintentional), sequela
- T56.3X1SToxic effect of cadmium and its compounds, accidental (unintentional), sequela
- T56.4X1SToxic effect of copper and its compounds, accidental (unintentional), sequela
- T56.5X1SToxic effect of zinc and its compounds, accidental (unintentional), sequela
- T56.6X1SToxic effect of tin and its compounds, accidental (unintentional), sequela
- T56.7X1SToxic effect of beryllium and its compounds, accidental (unintentional), sequela
- T56.811SToxic effect of thallium, accidental (unintentional), sequela
T56.94XS at a glance
| Code | T56.94XS |
|---|---|
| Description | Toxic effect of unspecified metal, undetermined, sequela |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "S" | sequela |
What does the 7th character "S" mean in T56.94XS?
In T56.94XS, the 7th character S means sequela. The 7th character is required for T56.94XS to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
Which MS-DRGs does T56.94XS group to?
T56.94XS 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.
- 922Other Injury, Poisoning and Toxic Effect Diagnoses with MCCmedical
- 923Other Injury, Poisoning and Toxic Effect Diagnoses without MCCmedical
Excludes1 — never code together — inherited from T51-T65
The conditions below can never be reported together with T56.94XS on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- contact with and (suspected) exposure to toxic substances (Z77.-)
Excludes1 — never code together — inherited from T56
The conditions below can never be reported together with T56.94XS on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
Use additional code — inherited from Chapter 19
Report an additional code alongside T56.94XS to fully describe the condition. T56.94XS is sequenced first.
- code to identify any retained foreign body, if applicable (Z18.-)
Use additional code — inherited from T51-T65
Report an additional code alongside T56.94XS to fully describe the condition. T56.94XS is sequenced first.
Use additional code — inherited from T56
Report an additional code alongside T56.94XS to fully describe the condition. T56.94XS is sequenced first.
Excludes2 — not included here — inherited from Chapter 19
The conditions below are not part of T56.94XS, but a patient may have both at the same time. When documentation supports it, T56.94XS and the excluded code may both be reported.
How long has T56.94XS existed?
T56.94XS 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.