T42.73XA ICD-10-CM Code: Poisoning by unspecified antiepileptic and sedative-hypnotic drugs, assault, initial encounter
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 917 — POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC (MDC 21)
- MS-DRG 918 — POISONING AND TOXIC EFFECTS OF DRUGS 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.
Official Registry Overview & Definition
Official Tabular Instructional Notes
Sequencing, inclusion, and exclusion notes published for T42.73XA 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
- 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
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).
- toxic reaction to local anesthesia in pregnancy (O29.3-) Compare T42.73XA vs O29.3 →
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- drug dependence and related mental and behavioral disorders due to psychoactive substance use (F10.--F19.-) Compare T42.73XA vs F10 →
- abuse and dependence of psychoactive substances (F10-F19) Compare T42.73XA vs F10 →
- abuse of non-dependence-producing substances (F55.-) Compare T42.73XA vs F55 →
- immunodeficiency due to drugs (D84.821) Compare T42.73XA vs D84.821 →
- drug reaction and poisoning affecting newborn (P00-P96) Compare T42.73XA vs P00 →
- pathological drug intoxication (inebriation) (F10-F19) Compare T42.73XA vs F10 →
Code First
Underlying conditions that must be sequenced before this code.
Frequently Compared Codes
The official Excludes notes on T42.73XA name these codes. Each comparison page covers when the two can — or must not — be reported together.
Change history
No changes recorded for this code — unchanged since the FY2016 baseline of the change ledger.
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.
Relationships & Classification
Other codes that name T42.73XA or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.
1 Excludes2 notes: F13.2 (via T42.-).
Potential MS-DRG 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 917 (MDC 21), DRG 918 (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):INJ022 — Poisoning by drugs, initial encounter (default); EXT014 — External cause codes: poisoning by drug; EXT022 — External cause codes: intent of injury, assault; MBD020 — Sedative-related disorders.
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.
T42.73XD — Poisoning by unspecified antiepileptic and sedative-hypnotic drugs, assault, subsequent encounter Compare T42.73XA vs T42.73XD →, T42.73XS — Poisoning by unspecified antiepileptic and sedative-hypnotic drugs, assault, sequela Compare T42.73XA vs T42.73XS →
Same clinical category (CCSR)
AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical categories (Poisoning by drugs, initial encounter, External cause codes: poisoning by drug, External cause codes: intent of injury, assault, Sedative-related disorders).
F13.94 — Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced mood disorder, F13.950 — Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced psychotic disorder with delusions, F13.951 — Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced psychotic disorder with hallucinations, F13.959 — Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced psychotic disorder, unspecified, F13.96 — Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced persisting amnestic disorder, F13.97 — Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced persisting dementia, F13.980 — Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced anxiety disorder, F13.981 — Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced sexual dysfunction, F13.982 — Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced sleep disorder, F13.988 — Sedative, hypnotic or anxiolytic use, unspecified with other sedative, hypnotic or anxiolytic-induced disorder, F13.99 — Sedative, hypnotic or anxiolytic use, unspecified with unspecified sedative, hypnotic or anxiolytic-induced disorder, T42.6X1A — Poisoning by other antiepileptic and sedative-hypnotic drugs, accidental (unintentional), initial encounter, T42.6X2A — Poisoning by other antiepileptic and sedative-hypnotic drugs, intentional self-harm, initial encounter, T42.6X3A — Poisoning by other antiepileptic and sedative-hypnotic drugs, assault, initial encounter, T42.6X4A — Poisoning by other antiepileptic and sedative-hypnotic drugs, undetermined, initial encounter, T42.6X5A — Adverse effect of other antiepileptic and sedative-hypnotic drugs, initial encounter, T42.71XA — Poisoning by unspecified antiepileptic and sedative-hypnotic drugs, accidental (unintentional), initial encounter, T42.72XA — Poisoning by unspecified antiepileptic and sedative-hypnotic drugs, intentional self-harm, initial encounter, T42.74XA — Poisoning by unspecified antiepileptic and sedative-hypnotic drugs, undetermined, initial encounter, T42.75XA — Adverse effect of unspecified antiepileptic and sedative-hypnotic drugs, initial encounter, +1063 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.
Contextual Map
Every relationship of T42.73XA 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]
- T42-T43 — Anticonvulsants & Psychotropics [Hierarchy]
Referenced by Excludes2 notes
- F13.2 — Sedative, hypnotic or anxiolytic-related dependence [Excludes2](via T42.-): “sedative, hypnotic, or anxiolytic poisoning (T42.-)” · check together
Clinical classification (CCSR)
- INJ022 — Poisoning by drugs, initial encounter [CCSR]
- EXT014 — External cause codes: poisoning by drug [CCSR]
- EXT022 — External cause codes: intent of injury, assault [CCSR]
- MBD020 — Sedative-related disorders [CCSR]
Potential MS-DRG
- DRG 917 — POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC [MS-DRG]: “POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC (MDC 21)”
- DRG 918 — POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC [MS-DRG]: “POISONING AND TOXIC EFFECTS OF DRUGS 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
Nearest codes (40)
- T42 — Poisoning by, adverse effect of and underdosing of antiepileptic, sedative- hypnotic and antiparkinsonism drugs [Sibling]
- T42.6X4D — Poisoning by other antiepileptic and sedative-hypnotic drugs, undetermined, subsequent encounter [Sibling]
- T42.6X4S — Poisoning by other antiepileptic and sedative-hypnotic drugs, undetermined, sequela [Sibling]
- T42.6X5 — Adverse effect of other antiepileptic and sedative-hypnotic drugs [Sibling]
- T42.6X5A — Adverse effect of other antiepileptic and sedative-hypnotic drugs, initial encounter [Sibling]
- T42.6X5D — Adverse effect of other antiepileptic and sedative-hypnotic drugs, subsequent encounter [Sibling]
- T42.6X5S — Adverse effect of other antiepileptic and sedative-hypnotic drugs, sequela [Sibling]
- T42.6X6 — Underdosing of other antiepileptic and sedative-hypnotic drugs [Sibling]
- and 32 more
Frequently Asked Questions (FAQ) & Clinical Guidance
Does T42.73XA require a 7th character?
Yes. The appropriate 7th character is to be added to each code from category T42.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to T42.73XA in its code family, with their registry titles.
- T42.72 — Poisoning by unspecified antiepileptic and sedative-hypnotic drugs, intentional self-harm
- T42.72XA — Poisoning by unspecified antiepileptic and sedative-hypnotic drugs, intentional self-harm, initial encounter
- T42.72XD — Poisoning by unspecified antiepileptic and sedative-hypnotic drugs, intentional self-harm, subsequent encounter
- T42.72XS — Poisoning by unspecified antiepileptic and sedative-hypnotic drugs, intentional self-harm, sequela
- T42.73 — Poisoning by unspecified antiepileptic and sedative-hypnotic drugs, assault
- T42.73XD — Poisoning by unspecified antiepileptic and sedative-hypnotic drugs, assault, subsequent encounter
- T42.73XS — Poisoning by unspecified antiepileptic and sedative-hypnotic drugs, assault, sequela
- T42.74 — Poisoning by unspecified antiepileptic and sedative-hypnotic drugs, undetermined
- T42.74XA — Poisoning by unspecified antiepileptic and sedative-hypnotic drugs, undetermined, initial encounter
- T42.74XD — Poisoning by unspecified antiepileptic and sedative-hypnotic drugs, undetermined, subsequent encounter