T40.495D
T40.495D — Adverse effect of other synthetic narcotics, subsequent encounter
Billable / specific codeICD-10-CMPOA exempt
T40.495D is a billable, specific ICD-10-CM code for adverse effect of other synthetic narcotics, subsequent encounter. It is valid for submission on a claim.
7th character "D" — subsequent 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
T40.495D does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
T40.495D is named in 13 Medicare coverage policies — 13 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56612Billing and Coding: CT of the Head
- A56645Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
- A56844Billing and Coding: RAST Type Tests
- A57077Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Related codes at this level
Codes that share T40.495. If T40.495D is not quite right, the correct code is usually one of these.
Questions about T40.495D
- Is T40.495D a billable ICD-10-CM code?
- Yes. T40.495D is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T40.495D 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).