T42 — Poisoning by, adverse effect of and underdosing of antiepileptic, sedative- hypnotic and antiparkinsonism drugs
T42 is a non-billable header ICD-10-CM code for poisoning by, adverse effect of and underdosing of antiepileptic, sedative- hypnotic and antiparkinsonism drugs. 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 T42
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Other codes that can never be billed with T42
These codes carry an Excludes1 note pointing at T42. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading T42 alone.
Risk adjustment
T42 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 to one of these instead T42
9 child codes. Green means billable.
- T42.0Poisoning by, adverse effect of and underdosing of hydantoin derivatives
- T42.1Poisoning by, adverse effect of and underdosing of iminostilbenes
- T42.2Poisoning by, adverse effect of and underdosing of succinimides and oxazolidinediones
- T42.3Poisoning by, adverse effect of and underdosing of barbiturates
- T42.4Poisoning by, adverse effect of and underdosing of benzodiazepines
- T42.5Poisoning by, adverse effect of and underdosing of mixed antiepileptics
- T42.6Poisoning by, adverse effect of and underdosing of other antiepileptic and sedative-hypnotic drugs
- T42.7Poisoning by, adverse effect of and underdosing of unspecified antiepileptic and sedative-hypnotic drugs
- T42.8Poisoning by, adverse effect of and underdosing of antiparkinsonism drugs and other central muscle-tone depressants
Questions about T42
- Is T42 a billable ICD-10-CM code?
- No. T42 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does T42 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).