O29.3 vs T44.99

O29.3 (Toxic reaction to local anesthesia during pregnancy) compared with T44.99 (Poisoning by, adverse effect of and underdosing of other drugs primarily affecting the autonomic nervous system), from the official CMS tabular data.

Summary

These codes should not be reported together because T44.99’s tabular entry lists O29.3 under Excludes1.

Official rule

What is different?

The conditions named and chapter.O29.3 is “Toxic reaction to local anesthesia during pregnancy”; T44.99 is “Poisoning by, adverse effect of and underdosing of other drugs primarily affecting the autonomic nervous system”. O29.3 sits in O00-O9A — Pregnancy, Childbirth and the Puerperium (O00-O9A); T44.99 in S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88).

Registry fact

Can these codes be reported together?

No.T44.99’s entry carries an Excludes1 note covering O29.3: “toxic reaction to local anesthesia in pregnancy (O29.3-)”. 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.T44.99’s tabular entry: “toxic reaction to local anesthesia in pregnancy (O29.3-)”. The note covers O29.3.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes2 relationship?

None.Neither entry carries an Excludes2 note that names the other code. O29.3 carries 4 Excludes2 notes and T44.99 carries 5 Excludes2 notes covering other codes; the side-by-side table quotes them.

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?

Both are headers.Both are non-billable headers, and neither contains the other.

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?

Conflict

Excludes1 conflict

T44.99

Poisoning by, adverse effect of and underdosing of other drugs primarily affecting the autonomic nervous system

↔

O29.3

Toxic reaction to local anesthesia during pregnancy

What we found

No — do not report together.T44.99 carries an Excludes1 note covering O29.3: “toxic reaction to local anesthesia in pregnancy (O29.3-)”

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 Excludes2 Check these on a claim

Why it matters

An Excludes1 note means the two conditions cannot occur together, so the pair should not be reported for the same encounter. The sole exception is when the conditions are documented as 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

	O29.3Toxic reaction to local anesthesia during pregnancy	T44.99Poisoning by, adverse effect of and underdosing of other drugs primarily affecting the autonomic nervous system
Billing status	Non-billable header Report instead: O29.3X1, O29.3X2, O29.3X3, O29.3X9	Non-billable header Report instead: T44.991A, T44.991D, T44.991S, T44.992A, T44.992D
Classification	O00-O9A — Pregnancy, Childbirth and the Puerperium (O00-O9A)	S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)
Definition	Toxic reaction to local anesthesia during pregnancy is a non-billable ICD-10-CM category code (O29.3).	Poisoning by, adverse effect of and underdosing of other drugs primarily affecting the autonomic nervous system is a non-billable ICD-10-CM category code (T44.99).
7th character	—	The appropriate 7th character is to be added to each code from category T44
Includes	maternal complications arising from the administration of a general, regional or local anesthetic, analgesic or other sedation during pregnancy	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
Excludes1	—	toxic reaction to local anesthesia in pregnancy (O29.3-)
Excludes2	complications of anesthesia during labor and delivery (O74.-) complications of anesthesia during the puerperium (O89.-) maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48) maternal diseases classifiable elsewhere but complicating pregnancy, labor and delivery, and the puerperium (O98-O99)	abuse and dependence of psychoactive substances (F10-F19) abuse of non-dependence-producing substances (F55.-) immunodeficiency due to drugs (D84.821) drug reaction and poisoning affecting newborn (P00-P96) pathological drug intoxication (inebriation) (F10-F19)
Code first	—	, for adverse effects, the nature of the adverse effect, such as: adverse effect NOS (T88.7)
Use additional code	code, if necessary, to identify the complication	code(s) to specify: manifestations of poisoning underdosing or failure in dosage during medical and surgical care (Y63.6, Y63.8-Y63.9)

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.

Edit this comparison Check a whole claim

Derived from the official CMS ICD-10-CM tabular data (FY2026). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources