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A05.1 vs T61

A05.1 (Botulism food poisoning) compared with T61 (Toxic effect of noxious substances eaten as seafood), from the official CMS tabular data.

Summary

These codes should not be reported together because A05.1’s tabular entry lists T61 under Excludes1.

Official rule
What is different?

The conditions named, billing status and chapter.A05.1 is “Botulism food poisoning”; T61 is “Toxic effect of noxious substances eaten as seafood”. T61 is a non-billable header; A05.1 is billable. A05.1 sits in A00-B99 — Certain Infectious and Parasitic Diseases (A00-B99); T61 in S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88).

Registry fact

Can these codes be reported together?

No.A05.1’s entry carries an Excludes1 note covering T61: “toxic effect of noxious foodstuffs (T61-T62)”. Both may be reported only when the documentation shows the two conditions are unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes1 relationship?

Yes.A05.1’s tabular entry: “toxic effect of noxious foodstuffs (T61-T62)”. The note covers T61.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes2 relationship?

None.Neither entry carries an Excludes2 note that names the other code.

Official rule

Is one more specific?

Not comparable.The codes sit in different categories; specificity is only comparable within one category.

Is one a parent or header code?

One is a header.T61 is a non-billable header, but A05.1 is not one of its subdivisions.

Registry fact

Are there sequencing instructions?

None.Neither entry carries a Code First or Use Additional Code note that names the other.

Official rule

Are there other coding relationships?

None found.No laterality, encounter-phase, Table of Neoplasms, Table of Drugs and Chemicals, or history-versus-active-disease relationship links these codes.

MedCoder-derived

Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule. How to read the labels

Can these codes be reported together?

Excludes1 — generally not reported together

Excludes1 conflict

A05.1
Botulism food poisoning
↔
T61
Toxic effect of noxious substances eaten as seafood

What we found

No — do not report together.A05.1 carries an Excludes1 note covering T61: “toxic effect of noxious foodstuffs (T61-T62)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

What to review

Report one of the two. Both may be reported only when the documentation shows the two conditions are unrelated to each other.

Guide: Excludes1 vs Excludes2Check these on a claim

Why it matters

An Excludes1 note means the two conditions are not ordinarily reported together for the same encounter, because the classification treats them as mutually exclusive forms of the same condition. The documented exception is when the two conditions are unrelated to each other.

Source / rule

CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a

Official guidance behind these answers

  • Section I.A.12.a — Excludes1 · applies to: Excludes1

    A type 1 Excludes note is a pure excludes note. It means “NOT CODED HERE!” An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition. An exception to the Excludes1 definition is the circumstance when the two conditions are unrelated to each other. If it is not clear whether the two conditions involving an Excludes1 note are related or not, query the provider. For example, code F45.8, Other somatoform disorders, has an Excludes1 note for "sleep related teeth grinding (G47.63)," because "teeth grinding" is an inclusion term under F45.8. Only one of these two codes should be assigned for teeth grinding. However psychogenic dysmenorrhea is also an inclusion term under F45.8, and a patient could have both this condition and sleep related teeth grinding. In this case, the two conditions are clearly unrelated to each other, and so it would be appropriate to report F45.8 and G47.63 together.

    ICD-10-CM Official Guidelines FY2026

Quoted from the ICD-10-CM Official Guidelines for Coding and Reporting in effect for the release shown. The tabular notes above are the code-level instruction; these sections are the convention that says how such a note is applied. Source document (CMS PDF) · Release and checksum

Side by side

A05.1Botulism food poisoningT61Toxic effect of noxious substances eaten as seafood
Billing statusBillableNon-billable header

Report instead: T61.01XA, T61.01XD, T61.01XS, T61.02XA, T61.02XD

ClassificationA00-B99 — Certain Infectious and Parasitic Diseases (A00-B99)S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)
DefinitionBotulism food poisoning is a billable ICD-10-CM diagnosis code (A05.1).Toxic effect of noxious substances eaten as seafood is a non-billable ICD-10-CM category code (T61).
7th character—The appropriate 7th character is to be added to each code from category T61
Includes
Botulism NOS
Classical foodborne intoxication due to Clostridium botulinum
—
Excludes1
infant botulism (A48.51)
wound botulism (A48.52)
Clostridium difficile foodborne intoxication and infection (A04.7-)
Escherichia coli infection (A04.0-A04.4)
listeriosis (A32.-)
salmonella foodborne intoxication and infection (A02.-)
toxic effect of noxious foodstuffs (T61-T62)
allergic reaction to food, such as:
anaphylactic reaction or shock due to adverse food reaction (T78.0-)
bacterial foodborne intoxications (A05.-)
dermatitis (L23.6, L25.4, L27.2)
food protein-induced enterocolitis syndrome (K52.21)
food protein-induced enteropathy (K52.22)
gastroenteritis (noninfective) (K52.29)
toxic effect of aflatoxin and other mycotoxins (T64)
toxic effect of cyanides (T65.0-)
toxic effect of harmful algae bloom (T65.82-)
toxic effect of hydrogen cyanide (T57.3-)
toxic effect of mercury (T56.1-)
toxic effect of red tide (T65.82-)
contact with and (suspected) exposure to toxic substances (Z77.-)
Use additional code—
code(s):
for all associated manifestations of toxic effect, such as: respiratory conditions due to external agents (J60-J70)
personal history of foreign body fully removed (Z87.821)

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on.

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Derived from the official CMS ICD-10-CM tabular data (FY2027). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources