T40.0X1A: Poisoning by opium, accidental (unintentional), initial encounter
T40.0X1A is a billable, specific ICD-10-CM code for poisoning by opium, accidental (unintentional), initial encounter. It is valid for submission on a claim.
Check T40.0X1A with the rest of the claim: free scrubber7th character "A": initial encounter
The appropriate 7th character is to be added to each code from category T40
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Poisoning by opium NOS
Excludes2 inherited from the categories above T40.0X1A
Not part of this code, but both may be coded when both are present.
Risk adjustment
T40.0X1A risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 137 Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications0.424 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
T40.0X1A is named in 10 Medicare coverage policies: 10 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A54799Billing and Coding: Urine Drug Testing
- A55001Billing and Coding: Urine Drug Testing
- A56500Billing and Coding: Cardiac Catheterization and Coronary Angiography
- A56612Billing and Coding: CT of the Head
Code history
Unchanged in every release from FY2024 to FY2027.