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T62.92XA vs T64

T62.92XA (Toxic effect of unspecified noxious substance eaten as food, intentional self-harm, initial encounter) compared with T64 (Toxic effect of aflatoxin and other mycotoxin food contaminants), from the official CMS tabular data.

Summary

These codes should not be reported together because T62.92XA’s tabular entry lists T64 under Excludes1.

Official rule
What is different?

Title wording and billing status.The titles share “Toxic effect of”; T62.92XA says “unspecified noxious substance eaten as food, intentional self-harm, initial encounter” where T64 says “aflatoxin and other mycotoxin food contaminants”. T64 is a non-billable header; T62.92XA is billable.

Registry fact

Can these codes be reported together?

No.T62.92XA’s entry carries an Excludes1 note covering T64: “toxic effect of aflatoxin and other mycotoxins (T64)”. Both may be reported only when the documentation shows the two conditions are unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes1 relationship?

Yes.T62.92XA’s tabular entry: “toxic effect of aflatoxin and other mycotoxins (T64)”. The note covers T64.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes2 relationship?

None.Neither entry carries an Excludes2 note that names the other code.

Official rule

Is one more specific?

Not comparable.The codes sit in different categories; specificity is only comparable within one category.

Is one a parent or header code?

One is a header.T64 is a non-billable header, but T62.92XA is not one of its subdivisions.

Registry fact

Are there sequencing instructions?

None.Neither entry carries a Code First or Use Additional Code note that names the other.

Official rule

Are there other coding relationships?

None found.No laterality, encounter-phase, Table of Neoplasms, Table of Drugs and Chemicals, or history-versus-active-disease relationship links these codes.

MedCoder-derived

Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule. How to read the labels

Can these codes be reported together?

Conflict

Excludes1 conflict

T62.92XA
Toxic effect of unspecified noxious substance eaten as food, intentional self-harm, initial encounter
↔
T64
Toxic effect of aflatoxin and other mycotoxin food contaminants

What we found

No — do not report together.T62.92XA carries an Excludes1 note covering T64: “toxic effect of aflatoxin and other mycotoxins (T64)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

What to review

Report one of the two. Both may be reported only when the documentation shows the two conditions are unrelated to each other.

Guide: Excludes1 vs Excludes2Check these on a claim

Why it matters

An Excludes1 note means the two conditions cannot occur together, so the pair should not be reported for the same encounter. The sole exception is when the conditions are documented as unrelated to each other.

Source / rule

CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a

Official guidance behind these answers

  • Section I.A.12.a — Excludes1 · applies to: Excludes1

    A type 1 Excludes note is a pure excludes note. It means “NOT CODED HERE!” An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition. An exception to the Excludes1 definition is the circumstance when the two conditions are unrelated to each other. If it is not clear whether the two conditions involving an Excludes1 note are related or not, query the provider. For example, code F45.8, Other somatoform disorders, has an Excludes1 note for "sleep related teeth grinding (G47.63)," because "teeth grinding" is an inclusion term under F45.8. Only one of these two codes should be assigned for teeth grinding. However psychogenic dysmenorrhea is also an inclusion term under F45.8, and a patient could have both this condition and sleep related teeth grinding. In this case, the two conditions are clearly unrelated to each other, and so it would be appropriate to report F45.8 and G47.63 together.

    ICD-10-CM Official Guidelines FY2026

Quoted from the ICD-10-CM Official Guidelines for Coding and Reporting in effect for the release shown. The tabular notes above are the code-level instruction; these sections are the convention that says how such a note is applied. Source document (CMS PDF) · Release and checksum

Side by side

T62.92XAToxic effect of unspecified noxious substance eaten as food, intentional self-harm, initial encounterT64Toxic effect of aflatoxin and other mycotoxin food contaminants
Billing statusBillableNon-billable header

Report instead: T64.01XA, T64.01XD, T64.01XS, T64.02XA, T64.02XD

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 noxious substance eaten as food, intentional self-harm, initial encounter is a billable ICD-10-CM diagnosis code (T62.92XA).Toxic effect of aflatoxin and other mycotoxin food contaminants is a non-billable ICD-10-CM category code (T64).
7th characterThe appropriate 7th character is to be added to each code from category T62The appropriate 7th character is to be added to each code from category T64
Excludes1
allergic reaction to food, such as:
anaphylactic shock (reaction) due to adverse food reaction (T78.0-)
bacterial food borne intoxications (A05.-)
dermatitis (L23.6, L25.4, L27.2)
food protein-induced enterocolitis syndrome (K52.21)
food protein-induced enteropathy (K52.22)
gastroenteritis (noninfective) (K52.29)
toxic effect of aflatoxin and other mycotoxins (T64)
toxic effect of cyanides (T65.0-)
toxic effect of hydrogen cyanide (T57.3-)
toxic effect of mercury (T56.1-)
contact with and (suspected) exposure to toxic substances (Z77.-)
contact with and (suspected) exposure to toxic substances (Z77.-)
Use additional code
code(s):
for all associated manifestations of toxic effect, such as: respiratory conditions due to external agents (J60-J70)
personal history of foreign body fully removed (Z87.821)
code(s):
for all associated manifestations of toxic effect, such as: respiratory conditions due to external agents (J60-J70)
personal history of foreign body fully removed (Z87.821)

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on.

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Derived from the official CMS ICD-10-CM tabular data (FY2027). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources