T51.94XA
T51.94XA — Toxic effect of unspecified alcohol, undetermined, initial encounter
Billable / specific codeICD-10-CM
T51.94XA is a billable, specific ICD-10-CM code for toxic effect of unspecified alcohol, 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 T51
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment
T51.94XA 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
T51.94XA is named in 2 Medicare coverage policies — 2 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
- A57205Billing and Coding: Oximetry Services
Related codes at this level
Codes that share T51.94. If T51.94XA is not quite right, the correct code is usually one of these.
Questions about T51.94XA
- Is T51.94XA a billable ICD-10-CM code?
- Yes. T51.94XA is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T51.94XA sit in the tabular list?
- Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Toxic effects of substances chiefly nonmedicinal as to source (T51-T65).