T50.994A — Poisoning by other drugs, medicaments and biological substances, undetermined, initial encounter
T50.994A is a billable, specific ICD-10-CM code for poisoning by other drugs, medicaments and biological substances, undetermined, 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 T50
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment
T50.994A 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
T50.994A is named in 6 Medicare coverage policies — 6 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
- A56948Billing and Coding: Lab: Cystatin C Measurement
- A56988Billing and Coding: Cystatin C Measurement
Related codes at this level
Codes that share T50.994. If T50.994A is not quite right, the correct code is usually one of these.
Questions about T50.994A
- Is T50.994A a billable ICD-10-CM code?
- Yes. T50.994A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T50.994A 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).