T48.204 vs T48.205
T48.204 (Poisoning by unspecified drugs acting on muscles, undetermined) compared with T48.205 (Adverse effect of unspecified drugs acting on muscles), from the official CMS tabular data. T48.204 and T48.205 code the same substance (Muscle-action) with a different intent.
Can these codes be reported together?
Same substance, different intent. T48.204 and T48.205 code the same substance (Muscle-action) 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
| T48.204Poisoning by unspecified drugs acting on muscles, undetermined | T48.205Adverse effect of unspecified drugs acting on muscles | |
|---|---|---|
| Billing status | Non-billable header | Non-billable header |
| 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 unspecified drugs acting on muscles, undetermined is a non-billable ICD-10-CM category code (T48.204). | Adverse effect of unspecified drugs acting on muscles is a non-billable ICD-10-CM category code (T48.205). |
| 7th character | The appropriate 7th character is to be added to each code from category T48 | The appropriate 7th character is to be added to each code from category T48 |
| 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