Is T40.5X a billable ICD-10-CM code?

No. T40.5X is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does T40.5X 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).

T40.5X

T40.5X — Poisoning by, adverse effect of and underdosing of cocaine

Non-billable headerICD-10-CM

T40.5X is a non-billable header ICD-10-CM code for poisoning by, adverse effect of and underdosing of cocaine. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.

This code requires a 7th character

The appropriate 7th character is to be added to each code from category T40

A: initial encounter
D: subsequent encounter
S: sequela

Excludes2 inherited from the categories above T40.5X

Also inherited, and the opposite of Excludes1: these conditions are not part of T40.5X, but a patient can have both, so you may code both.

Written on T40 — Poisoning by, adverse effect of and underdosing of narcotics and psychodysleptics [hallucinogens]

drug dependence and related mental and behavioral disorders due to psychoactive substance use (F10.-F19.-)

Risk adjustment

T40.5X 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.

Code history

T40.5X has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Code to one of these instead T40.5X

6 child codes. Green means billable.

Questions about T40.5X

Is T40.5X a billable ICD-10-CM code?: No. T40.5X is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does T40.5X 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).