Is T63.004S a billable ICD-10-CM code?

Yes. T63.004S is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does T63.004S 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).

T63.004S

T63.004S — Toxic effect of unspecified snake venom, undetermined, sequela

Billable / specific codeICD-10-CMPOA exempt

T63.004S is a billable, specific ICD-10-CM code for toxic effect of unspecified snake venom, undetermined, sequela. It is valid for submission on a claim.

7th character "S" — sequela

The appropriate 7th character is to be added to each code from category T63

A: initial encounter
D: subsequent encounter
S: sequela

Excludes2 inherited from the categories above T63.004S

Also inherited, and the opposite of Excludes1: these conditions are not part of T63.004S, but a patient can have both, so you may code both.

Written on T63 — Toxic effect of contact with venomous animals and plants

ingestion of toxic animal or plant (T61.-, T62.-)

Other codes that can never be billed with T63.004S

These codes carry an Excludes1 note pointing at T63.004S. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading T63.004S alone.

W64Exposure to other animate mechanical forces
W64.XXXAExposure to other animate mechanical forces, initial encounter
W64.XXXDExposure to other animate mechanical forces, subsequent encounter
W64.XXXSExposure to other animate mechanical forces, sequela
W56Contact with nonvenomous marine animal

Risk adjustment

T63.004S 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

T63.004S is named in 13 Medicare coverage policies — 13 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A56559Billing and Coding: Allergy Skin Testing
A56559Billing and Coding: Allergy Skin Testing
A56612Billing and Coding: CT of the Head
A60360Billing and Coding: Allergy Diagnostic Testing

Code history

T63.004S 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 T63.004. If T63.004S is not quite right, the correct code is usually one of these.

Questions about T63.004S

Is T63.004S a billable ICD-10-CM code?: Yes. T63.004S is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does T63.004S 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).