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T47.8X4 vs T47.8X5

T47.8X4 (Poisoning by other agents primarily affecting gastrointestinal system, undetermined) compared with T47.8X5 (Adverse effect of other agents primarily affecting gastrointestinal system), from the official CMS tabular data. T47.8X4 and T47.8X5 code the same substance (Algin) with a different intent.

Relationship

Informational

Drug table relationship

T47.8X4
Poisoning by other agents primarily affecting gastrointestinal system, undetermined
T47.8X5
Adverse effect of other agents primarily affecting gastrointestinal system

Same substance, different circumstance of exposure.

Same substance — adverse effect (Algin)

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. T47.8X4 and T47.8X5 code the same substance (Algin) 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

T47.8X4Poisoning by other agents primarily affecting gastrointestinal system, undeterminedT47.8X5Adverse effect of other agents primarily affecting gastrointestinal system
Billing statusNon-billable header

Report instead: T47.8X4A, T47.8X4D, T47.8X4S

Non-billable header

Report instead: T47.8X5A, T47.8X5D, T47.8X5S

ClassificationS00-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)
DefinitionPoisoning by other agents primarily affecting gastrointestinal system, undetermined is a non-billable ICD-10-CM category code (T47.8X4).Adverse effect of other agents primarily affecting gastrointestinal system is a non-billable ICD-10-CM category code (T47.8X5).
7th characterThe appropriate 7th character is to be added to each code from category T47The appropriate 7th character is to be added to each code from category T47
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