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T56.93XA vs T56.93XD

T56.93XA (Toxic effect of unspecified metal, assault, initial encounter) compared with T56.93XD (Toxic effect of unspecified metal, assault, subsequent encounter), from the official CMS tabular data. T56.93XA and T56.93XD code the same injury at a different phase of treatment.

Relationship

Review

Encounter relationship

T56.93XA
Initial encounter
Toxic effect of unspecified metal, assault, initial encounter
T56.93XD
Subsequent encounter
Toxic effect of unspecified metal, assault, subsequent encounter

Same underlying diagnosis, different encounter phase.

The 7th character records the phase of care for the encounter being coded, so a single encounter takes one of these characters, not several. Review whether both phases belong on the same episode of care.

Source: ICD-10-CM Official Guidelines, Section I.C.19.a

Can these codes be reported together?

Same injury, other encounter phase. T56.93XA and T56.93XD code the same injury at a different phase of treatment, set by the 7th character.

The 7th character records the type of care given at the encounter being coded (ICD-10-CM Official Guidelines, Section I.C.19.a), so one encounter takes one of these, not both.

Side by side

T56.93XAToxic effect of unspecified metal, assault, initial encounterT56.93XDToxic effect of unspecified metal, assault, subsequent encounter
Billing statusBillableBillable
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)
DefinitionToxic effect of unspecified metal, assault, initial encounter is a billable ICD-10-CM diagnosis code (T56.93A).Toxic effect of unspecified metal, assault, subsequent encounter is a billable ICD-10-CM diagnosis code (T56.93D).
7th characterThe appropriate 7th character is to be added to each code from category T56The appropriate 7th character is to be added to each code from category T56
Includes
toxic effects of fumes and vapors of metals
toxic effects of metals from all sources, except medicinal substances
toxic effects of fumes and vapors of metals
toxic effects of metals from all sources, except medicinal substances
Use additional code
code to identify any retained metal foreign body, if applicable (Z18.0-, T18.1-)
code(s):
for all associated manifestations of toxic effect, such as: respiratory conditions due to external agents (J60-J70)
code to identify any retained metal foreign body, if applicable (Z18.0-, T18.1-)
code(s):
for all associated manifestations of toxic effect, such as: respiratory conditions due to external agents (J60-J70)

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources