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T48.204 vs T48.206

T48.204 (Poisoning by unspecified drugs acting on muscles, undetermined) compared with T48.206 (Underdosing of unspecified drugs acting on muscles), from the official CMS tabular data. T48.204 and T48.206 code the same substance (Muscle-action) with a different intent.

Relationship

Informational

Drug table relationship

T48.204
Poisoning by unspecified drugs acting on muscles, undetermined
T48.206
Underdosing of unspecified drugs acting on muscles

Same substance, different circumstance of exposure.

Same substance — underdosing (Muscle-action)

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. T48.204 and T48.206 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, undeterminedT48.206Underdosing of unspecified drugs acting on muscles
Billing statusNon-billable headerNon-billable header
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 unspecified drugs acting on muscles, undetermined is a non-billable ICD-10-CM category code (T48.204).Underdosing of unspecified drugs acting on muscles is a non-billable ICD-10-CM category code (T48.206).
7th characterThe appropriate 7th character is to be added to each code from category T48The 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