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T65.224A vs T65.224S

T65.224A (Toxic effect of tobacco cigarettes, undetermined, initial encounter) compared with T65.224S (Toxic effect of tobacco cigarettes, undetermined, sequela), from the official CMS tabular data. T65.224A and T65.224S code the same injury at a different phase of treatment.

Can these codes be reported together?

Same injury, other encounter phase. T65.224A and T65.224S 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

T65.224AToxic effect of tobacco cigarettes, undetermined, initial encounterT65.224SToxic effect of tobacco cigarettes, undetermined, sequela
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 tobacco cigarettes, undetermined, initial encounter is a billable ICD-10-CM diagnosis code (T65.224A).Toxic effect of tobacco cigarettes, undetermined, sequela is a billable ICD-10-CM diagnosis code (T65.224S).
7th characterThe appropriate 7th character is to be added to each code from category T65The appropriate 7th character is to be added to each code from category T65
Use additional code
code for exposure to second hand tobacco smoke (Z57.31, Z77.22)
code(s):
for all associated manifestations of toxic effect, such as: respiratory conditions due to external agents (J60-J70)
code for exposure to second hand tobacco smoke (Z57.31, Z77.22)
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