T40.411A — Poisoning by fentanyl or fentanyl analogs, accidental (unintentional), initial encounter
T40.411A is a billable, specific ICD-10-CM code for poisoning by fentanyl or fentanyl analogs, accidental (unintentional), 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 T40
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment
T40.411A 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.
Medicare coverage
T40.411A is named in 3 Medicare coverage policies — 3 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56915Billing and Coding: Urine Drug Testing
- A57473Billing and Coding: Allergy Testing
- A57473Billing and Coding: Allergy Testing
Related codes at this level
Codes that share T40.411. If T40.411A is not quite right, the correct code is usually one of these.
Questions about T40.411A
- Is T40.411A a billable ICD-10-CM code?
- Yes. T40.411A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T40.411A 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).