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F19 vs T40.494D

F19 (Other psychoactive substance related disorders) compared with T40.494D (Poisoning by other synthetic narcotics, undetermined, subsequent encounter), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).

Relationship

Informational

Excludes2 relationship

T40.494D
Poisoning by other synthetic narcotics, undetermined, subsequent encounter
↔
F19
Other psychoactive substance related disorders

Distinct conditions — both may be reported.

“drug dependence and related mental and behavioral disorders due to psychoactive substance use (F10.-F19.-)”

An Excludes2 note means the excluded condition is not part of the code above it, but a patient can have both. Report both when both are documented.

Source: CMS ICD-10-CM tabular instructional notes

Can these codes be reported together?

Yes, when both are documented. T40.494D carries an Excludes2 note covering F19: “drug dependence and related mental and behavioral disorders due to psychoactive substance use (F10.-F19.-)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

Side by side

F19Other psychoactive substance related disordersT40.494DPoisoning by other synthetic narcotics, undetermined, subsequent encounter
Billing statusNon-billable header

Report instead: F19.10, F19.11, F19.120, F19.121, F19.122

Billable
ClassificationF01-F99 — Mental, Behavioral and Neurodevelopmental Disorders (F01-F99)S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)
DefinitionOther psychoactive substance related disorders is a non-billable ICD-10-CM category code (F19).Poisoning by other synthetic narcotics, undetermined, subsequent encounter is a billable ICD-10-CM diagnosis code (T40.494D).
7th character—The appropriate 7th character is to be added to each code from category T40
Includes
polysubstance drug use (indiscriminate drug use)
adverse effect of correct substance properly administered
poisoning by overdose of substance
poisoning by wrong substance given or taken in error
underdosing by (inadvertently) (deliberately) taking less substance than prescribed or instructed
Use additional code—
code(s) to specify:
manifestations of poisoning
underdosing or failure in dosage during medical and surgical care (Y63.6, Y63.8-Y63.9)
Code first—
, for adverse effects, the nature of the adverse effect, such as:
adverse effect NOS (T88.7)
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Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources