T40.5X1 vs T41.3
T40.5X1 (Poisoning by cocaine, accidental (unintentional)) compared with T41.3 (Poisoning by, adverse effect of and underdosing of local anesthetics), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.
Can these codes be reported together?
No — do not report together. T41.3 carries an Excludes1 note covering T40.5X1: “cocaine (T40.5-)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
Yes, when both are documented. T41.3 carries an Excludes2 note covering T40.5X1: “poisoning by cocaine used as a central nervous system stimulant (T40.5X1-T40.5X4)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| T40.5X1Poisoning by cocaine, accidental (unintentional) | T41.3Poisoning by, adverse effect of and underdosing of local anesthetics | |
|---|---|---|
| Billing status | Non-billable header | Non-billable header Report instead: T41.3X1A, T41.3X1D, T41.3X1S, T41.3X2A, T41.3X2D |
| Classification | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) |
| Definition | Poisoning by cocaine, accidental (unintentional) is a non-billable ICD-10-CM category code (T40.5X1). | Poisoning by, adverse effect of and underdosing of local anesthetics is a non-billable ICD-10-CM category code (T41.3). |
| 7th character | The appropriate 7th character is to be added to each code from category T40 | The appropriate 7th character is to be added to each code from category T41 |
| Includes | 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 | 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(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) | , for adverse effects, the nature of the adverse effect, such as: adverse effect NOS (T88.7) |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources