T42.6X1S

T42.6X1S: Poisoning by other antiepileptic and sedative-hypnotic drugs, accidental (unintentional), sequela

Billable / specific codeICD-10-CMPOA exempt

T42.6X1S is a billable, specific ICD-10-CM code for poisoning by other antiepileptic and sedative-hypnotic drugs, accidental (unintentional), sequela. It is valid for submission on a claim.

Check T42.6X1S with the rest of the claim: free scrubber

7th character "S": sequela

The appropriate 7th character is to be added to each code from category T42

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 other antiepileptic and sedative-hypnotic drugs NOS

Excludes1 inherited from the categories above T42.6X1S

A category’s note binds every code beneath it.

Written on T42.6: Poisoning by, adverse effect of and underdosing of other antiepileptic and sedative-hypnotic drugs

poisoning by, adverse effect of and underdosing of carbamazepine (T42.1-)

Excludes2 inherited from the categories above T42.6X1S

Not part of this code, but both may be coded when both are present.

Written on T42: Poisoning by, adverse effect of and underdosing of antiepileptic, sedative- hypnotic and antiparkinsonism drugs

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

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

T42.6X1S is named in 1 Medicare coverage policy: 1 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A56612Billing and Coding: CT of the Head

Code history

Unchanged in every release from FY2024 to FY2027.