T63.92XA

T63.92XA: Toxic effect of contact with unspecified venomous animal, intentional self-harm, initial encounter

Billable / specific codeICD-10-CM

T63.92XA is a billable, specific ICD-10-CM code for toxic effect of contact with unspecified venomous animal, intentional self-harm, initial encounter. It is valid for submission on a claim.

Check T63.92XA 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 T63.92XA

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 T63.92XA

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

T63.92XA 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.

Medicare coverage

T63.92XA is named in 4 Medicare coverage policies: 4 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A56558Billing and Coding: Allergy Testing
A56612Billing and Coding: CT of the Head
A57205Billing and Coding: Oximetry Services
A57531Billing and Coding: Allergy Testing

Code history

Unchanged in every release from FY2024 to FY2027.