T63.461A

T63.461A: Toxic effect of venom of wasps, accidental (unintentional), initial encounter

Billable / specific codeICD-10-CM

T63.461A is a billable, specific ICD-10-CM code for toxic effect of venom of wasps, accidental (unintentional), initial encounter. It is valid for submission on a claim.

Check T63.461A with the rest of the claim: free scrubber

7th character "A": initial encounter

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 T63.461A

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

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 T63.461A

Their own Excludes1 notes name this code, so the conflict is not listed above.

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

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

Medicare coverage

T63.461A is named in 19 Medicare coverage policies: 19 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A56538Billing and Coding: Allergen Immunotherapy
A56558Billing and Coding: Allergy Testing
A56612Billing and Coding: CT of the Head
A56844Billing and Coding: RAST Type Tests

Code history

Unchanged in every release from FY2024 to FY2027.