T46.4X4 vs T46.4X5

T46.4X4 (Poisoning by angiotensin-converting-enzyme inhibitors, undetermined) compared with T46.4X5 (Adverse effect of angiotensin-converting-enzyme inhibitors), from the official CMS tabular data. T46.4X4 and T46.4X5 code the same substance (Alacepril) with a different intent.

Relationship

Informational

Drug table relationship

T46.4X4

Poisoning by angiotensin-converting-enzyme inhibitors, undetermined

↔

T46.4X5

Adverse effect of angiotensin-converting-enzyme inhibitors

Same substance, different circumstance of exposure.

Same substance — adverse effect (Alacepril)

Accidental poisoning, intentional self-harm, assault, undetermined intent, adverse effect and underdosing are mutually exclusive columns — exactly one applies to a given encounter.

Source: CMS Table of Drugs and Chemicals

Can these codes be reported together?

Same substance, different intent. T46.4X4 and T46.4X5 code the same substance (Alacepril) with a different circumstance of exposure.

From the CMS Table of Drugs and Chemicals: accidental poisoning, intentional self-harm, assault, undetermined intent, adverse effect and underdosing are mutually exclusive columns — only one of them applies to a given encounter.

Side by side

	T46.4X4Poisoning by angiotensin-converting-enzyme inhibitors, undetermined	T46.4X5Adverse effect of angiotensin-converting-enzyme inhibitors
Billing status	Non-billable header Report instead: T46.4X4A, T46.4X4D, T46.4X4S	Non-billable header Report instead: T46.4X5A, T46.4X5D, T46.4X5S
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 angiotensin-converting-enzyme inhibitors, undetermined is a non-billable ICD-10-CM category code (T46.4X4).	Adverse effect of angiotensin-converting-enzyme inhibitors is a non-billable ICD-10-CM category code (T46.4X5).
7th character	The appropriate 7th character is to be added to each code from category T46	The appropriate 7th character is to be added to each code from category T46
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)

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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