T65.94XA — Toxic effect of unspecified substance, undetermined, initial encounter
Is T65.94XA billable?
Yes, but T65.94XA is an unspecified code. T65.94XA is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, T65.94XA 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 T65.94XA.
T65.94XA at a glance
| Code | T65.94XA |
|---|---|
| Description | Toxic effect of unspecified substance, undetermined, 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 T65.94XA?
In T65.94XA, the 7th character A means initial encounter. The 7th character is required for T65.94XA to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
Which MS-DRGs does T65.94XA group to?
T65.94XA 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 T51-T65
The conditions below can never be reported together with T65.94XA 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.-)
Use additional code — inherited from Chapter 19
Report an additional code alongside T65.94XA to fully describe the condition. T65.94XA 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 T65.94XA to fully describe the condition. T65.94XA is sequenced first.
Excludes2 — not included here — inherited from Chapter 19
The conditions below are not part of T65.94XA, but a patient may have both at the same time. When documentation supports it, T65.94XA and the excluded code may both be reported.
How long has T65.94XA existed?
T65.94XA 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.