T56.92XA — Toxic effect of unspecified metal, intentional self-harm, initial encounter
T56.92XA is a billable, specific ICD-10-CM code for toxic effect of unspecified metal, intentional self-harm, 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 T56
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Excludes1 inherited from the categories above T56.92XA
These are not written on T56.92XA, but they bind it: a note on a category applies to every code beneath it. Billing T56.92XA with anything listed here is a denial.
Risk adjustment
T56.92XA risk-adjusts. Under the CMS-HCC V28 model it maps to these categories:
- HCC 155 Major Depression, Moderate or Severe, without Psychosis0.299 RAF
- HCC 155 Major Depression, Moderate or Severe, without Psychosis0.299 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
T56.92XA 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
Code history
T56.92XA has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share T56.92. If T56.92XA is not quite right, the correct code is usually one of these.
Questions about T56.92XA
- Is T56.92XA a billable ICD-10-CM code?
- Yes. T56.92XA is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T56.92XA 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).
- What cannot be coded together with T56.92XA?
- T56.92XA carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above T56.92XA (T56) and apply to it just the same.