T38.5X2A — Poisoning by other estrogens and progestogens, intentional self-harm, initial encounter
T38.5X2A is a billable, specific ICD-10-CM code for poisoning by other estrogens and progestogens, intentional self-harm, initial encounter. It is valid for submission on a claim.
7th character "A" — initial encounter
The appropriate 7th character is to be added to each code from category T38
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Excludes1 inherited from the categories above T38.5X2A
These are not written on T38.5X2A, but they bind it: a note on a category applies to every code beneath it. Billing T38.5X2A with anything listed here is a denial.
Risk adjustment
T38.5X2A risk-adjusts. Under the CMS-HCC V28 model it maps to these categories:
- HCC 155 Major Depression, Moderate or Severe, without Psychosis0.299 RAF
- HCC 155 Major Depression, Moderate or Severe, without Psychosis0.299 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
T38.5X2A is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A57205Billing and Coding: Oximetry Services
Code history
T38.5X2A has not changed since FY2024 — no addition, revision or deletion across the FY2024–FY2027 ICD-10-CM releases.
Related codes at this level
Codes that share T38.5X2. If T38.5X2A is not quite right, the correct code is usually one of these.
Questions about T38.5X2A
- Is T38.5X2A a billable ICD-10-CM code?
- Yes. T38.5X2A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T38.5X2A sit in the tabular list?
- Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Poisoning by, adverse effects of and underdosing of drugs, medicaments and biological substances (T36-T50).
- What cannot be coded together with T38.5X2A?
- T38.5X2A carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above T38.5X2A (T38) and apply to it just the same.