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T40.414S ICD-10-CM Code: Poisoning by fentanyl or fentanyl analogs, undetermined, sequela

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Inpatient Payment Groups (MS-DRG)

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, Appendix B.

  • MS-DRG 922 — OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC (MDC 21)
  • MS-DRG 923 — OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC (MDC 21)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Code Overview

Poisoning by fentanyl or fentanyl analogs, undetermined, sequela is a billable ICD-10-CM diagnosis code (T40.414S).

Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for T40.414S in the official ICD-10-CM tabular list.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • adverse effect of correct substance properly administered inherited from T36-T50
  • poisoning by overdose of substance inherited from T36-T50
  • poisoning by wrong substance given or taken in error inherited from T36-T50
  • underdosing by (inadvertently) (deliberately) taking less substance than prescribed or instructed inherited from T36-T50

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Code First

Underlying conditions that must be sequenced before this code.

  • Code first, for adverse effects, the nature of the adverse effect, such as: inherited from T36-T50
  • adverse effect NOS (T88.7) inherited from T36-T50
  • aspirin gastritis (K29.-) inherited from T36-T50
  • blood disorders (D56-D76) inherited from T36-T50
  • contact dermatitis (L23-L25) inherited from T36-T50
  • dermatitis due to substances taken internally (L27.-) inherited from T36-T50
  • nephropathy (N14.0-N14.2) inherited from T36-T50

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code(s) to specify: inherited from T36-T50
  • manifestations of poisoning inherited from T36-T50
  • underdosing or failure in dosage during medical and surgical care (Y63.6, Y63.8-Y63.9) inherited from T36-T50
  • underdosing of medication regimen (Z91.12-, Z91.13-) inherited from T36-T50

Associated Substances (3)

Substances from the official ICD-10-CM Table of Drugs and Chemicals that map to this code.

  • Alfentanil
  • Fentanyl (analogs)
  • Sufentanil

Frequently Compared Codes

The official Excludes notes on T40.414S name these codes. Each comparison page covers when the two can — or must not — be reported together.

Change history

  • FY2021 — 2020-10-01
    Added to the code set
    Poisoning by fentanyl or fentanyl analogs, undetermined, sequela
    FY2021 changes

Verify Before Coding

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MS-DRG Grouper Relationships (FY2026)

Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.

Named in the grouper logic of 2 MS-DRGs: DRG 922 (MDC 21), DRG 923 (MDC 21).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):MBD034 — Mental and substance use disorders; sequela (default); INJ075 — Poisoning/toxic effect/adverse effects/underdosing, sequela.

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same injury, other encounter phase

Same injury, coded at a different phase of treatment via the 7th character.

T40.414A — Poisoning by fentanyl or fentanyl analogs, undetermined, initial encounter Compare T40.414S vs T40.414A →, T40.414D — Poisoning by fentanyl or fentanyl analogs, undetermined, subsequent encounter

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical categories (Mental and substance use disorders; sequela, Poisoning/toxic effect/adverse effects/underdosing, sequela).

+1655 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Gamma-glutamyl Transferase (GGT) Test, Iron Panel, Partial Thromboplastin Time (PTT) Test, Prothrombin Time Test and INR (PT/INR)

Contextual Map

Every relationship of T40.414S in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Hierarchy

  • S00-T88 — Chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) (S00-T88) [Hierarchy]
  • T36-T50 — Poisoning by, adverse effects of and underdosing of drugs, medicaments and biological substances [Hierarchy]
  • T40-T41 — Analgesics & Antipyretics [Hierarchy]

Clinical classification (CCSR)

  • MBD034 — Mental and substance use disorders; sequela [CCSR]
  • INJ075 — Poisoning/toxic effect/adverse effects/underdosing, sequela [CCSR]

MS-DRG Grouper

  • DRG 922 — OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC [MS-DRG]: “OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC (MDC 21)”
  • DRG 923 — OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC [MS-DRG]: “OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC (MDC 21)”

MDC crossing · procedures (32029)

  • MDC 21 — Injuries, Poisonings and Toxic Effects of Drugs [MDC crossing]: “Injuries, Poisonings and Toxic Effects of Drugs — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
  • 0016070 — Bypass Cerebral Ventricle to Nasopharynx with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Nasopharynx with Autologous Tissue Substitute, Open Approach — grouped in MDC 21, the procedure side of this code's crossing.” · check together
  • 0016071 — Bypass Cerebral Ventricle to Mastoid Sinus with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Mastoid Sinus with Autologous Tissue Substitute, Open Approach — grouped in MDC 21, the procedure side of this code's crossing.” · check together
  • 0016072 — Bypass Cerebral Ventricle to Atrium with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Atrium with Autologous Tissue Substitute, Open Approach — grouped in MDC 21, the procedure side of this code's crossing.” · check together
  • 0016073 — Bypass Cerebral Ventricle to Blood Vessel with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Blood Vessel with Autologous Tissue Substitute, Open Approach — grouped in MDC 21, the procedure side of this code's crossing.” · check together
  • 0016074 — Bypass Cerebral Ventricle to Pleural Cavity with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Pleural Cavity with Autologous Tissue Substitute, Open Approach — grouped in MDC 21, the procedure side of this code's crossing.” · check together
  • and 32024 more

Drugs & chemicals

  • Alfentanil — Alfentanil — Poisoning, Undetermined [Drug table]: “Alfentanil (Poisoning, Undetermined)”
  • Fentanyl (analogs) — Fentanyl (analogs) — Poisoning, Undetermined [Drug table]: “Fentanyl (analogs) (Poisoning, Undetermined)”
  • Sufentanil — Sufentanil — Poisoning, Undetermined [Drug table]: “Sufentanil (Poisoning, Undetermined)”

Nearest codes (40)

  • T40 — Poisoning by, adverse effect of and underdosing of narcotics and psychodysleptics [hallucinogens] [Sibling]
  • T40.3X6A — Underdosing of methadone, initial encounter [Sibling]
  • T40.3X6D — Underdosing of methadone, subsequent encounter [Sibling]
  • T40.3X6S — Underdosing of methadone, sequela [Sibling]
  • T40.4 — Poisoning by, adverse effect of and underdosing of other synthetic narcotics [Sibling]
  • T40.41 — Poisoning by, adverse effect of and underdosing of fentanyl or fentanyl analogs [Sibling]
  • T40.411 — Poisoning by fentanyl or fentanyl analogs, accidental (unintentional) [Sibling]
  • T40.411A — Poisoning by fentanyl or fentanyl analogs, accidental (unintentional), initial encounter [Sibling]
  • and 32 more

Change history

  • FY2021 — Added to the code set [Change history]

Frequently Asked Questions (FAQ) & Clinical Guidance

Does T40.414S require a 7th character?

Yes. The appropriate 7th character is to be added to each code from category T40.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to T40.414S in its code family, with their registry titles.

  • T40.413D — Poisoning by fentanyl or fentanyl analogs, assault, subsequent encounter
  • T40.413S — Poisoning by fentanyl or fentanyl analogs, assault, sequela
  • T40.414 — Poisoning by fentanyl or fentanyl analogs, undetermined
  • T40.414A — Poisoning by fentanyl or fentanyl analogs, undetermined, initial encounter
  • T40.414D — Poisoning by fentanyl or fentanyl analogs, undetermined, subsequent encounter
  • T40.415 — Adverse effect of fentanyl or fentanyl analogs
  • T40.415A — Adverse effect of fentanyl or fentanyl analogs, initial encounter
  • T40.415D — Adverse effect of fentanyl or fentanyl analogs, subsequent encounter
  • T40.415S — Adverse effect of fentanyl or fentanyl analogs, sequela
  • T40.416 — Underdosing of fentanyl or fentanyl analogs

View all codes in the T40 family