T57.2X1D ICD-10-CM Code: Toxic effect of manganese and its compounds, accidental (unintentional), subsequent encounter
Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.
Coding at a Glance
- 7th character
- Required — see the character table on this page
- Tabular directives
- 1 inclusion term · 1 Excludes1 · 4 use-additional codes
Inpatient Payment Groups (MS-DRG)
Potential MS-DRG participation — not a DRG assignment.
MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.
- MS-DRG 949 — AFTERCARE WITH CC/MCC (MDC 23)
- MS-DRG 950 — AFTERCARE WITHOUT CC/MCC (MDC 23)
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.
Coding instructions
Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for T57.2X1D in the official ICD-10-CM tabular list, quoted as published.
Notes without a marker are published on T57.2X1D itself; “inherited from” names the category or block whose note applies here.
Inclusion Terms
Alternative terms the tabular list files under this code.
- Toxic effect of manganese and its compounds NOS
Source: inherited from T57.2X1
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).
- contact with and (suspected) exposure to toxic substances (Z77.-) Compare T57.2X1D vs Z77 →
Source: inherited from T51-T65
Use Additional Code
Supplementary codes the tabular list directs you to add.
- Use additional 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)
- to identify any retained foreign body, if applicable (Z18.-)
Source: inherited from T51-T65
7th Character Guide
"The appropriate 7th character is to be added to each code from category T57"
- A — initial encounter
- D — subsequent encounter (this page’s code)
- S — sequela
How the encounter character is assigned. “Initial encounter” means the patient is receiving active treatment for the condition — it is not limited to the first visit, and a different or new provider giving active treatment still assigns it. “Subsequent encounter” covers care during the healing or recovery phase after active treatment. “Sequela” is for complications or conditions that arise as a direct result of the original condition.
ICD-10-CM Official Guidelines for Coding and Reporting, Section I.C.19.a (paraphrased by MedCoder).
Variant codes in this family
Character meanings are CMS's official 7th-character extensions for this family, as carried in each variant code's official description; variant codes are registry rows. The explanation of how the encounter character is assigned is MedCoder editorial, distinct from the official content above it.
Coder workflow for T57.2X1D
MedCoder structured workflow — derived from this code’s own official record
Before you code T57.2X1D
- A 7th character is required in this family. Confirm the documented encounter: initial (active treatment), subsequent (healing or recovery phase), or sequela. This page’s code carries “D”. “Initial” means active treatment, not the first visit (Guidelines I.C.19.a).
See the 7th Character Guide · Guide: 7th characters: initial, subsequent, sequela →
- Confirm whether the documentation describes a poisoning, an adverse effect of a correctly prescribed and administered drug, an underdosing, or a toxic effect, and the intent where the record states it: the Table of Drugs and Chemicals separates these by column, and the sequencing differs for each. Poisoning, adverse effect and underdosing guidelines (Guidelines I.C.19.e).
See the Table of Drugs and Chemicals entries · Guide: Poisoning vs adverse effect vs underdosing →
- Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with T57.2X1D. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).
Choose the right path
- Does the documentation support a condition named in T57.2X1D’s Excludes1 note?
Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
No → Continue.ReviewZ77
- Is the encounter phase documented — active treatment, healing or recovery, or a sequela?
Yes → Assign the matching 7th character; the variant codes are in the 7th Character Guide.
No → The code is invalid without its 7th character — query for the missing element.
Consider T57.2X1D. Then work the Use Additional Code note, and confirm the code is valid for the date of service in the Verify section.
Documentation check
- The provider’s diagnostic statement
- Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
- Encounter type
- Active treatment, healing or recovery phase, or sequela — the basis of the 7th character (Guidelines I.C.19.a).
- The conditions the Use Additional Code note names
- Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.
- External cause, place and activity
- For the external cause codes reported with the injury or poisoning, where documented (Guidelines I.C.20.a).
Official instructions as workflow
Excludes1 — check before selecting T57.2X1D(1 note)
Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with T57.2X1D: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.
CompareZ77
See the official tabular notes · Guidelines I.A.12.a
Use Additional Code — after identifying T57.2X1D(4 notes)
Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with T57.2X1D when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.
See the official tabular notes · Guidelines I.A.13
Coding decision scenarios
Pattern scenarios for this code’s structure — decision rules, not clinical cases
Documentation: Both the condition T57.2X1D describes and a condition named in its Excludes1 note are documented for the same encounter.
Coding question: Can both codes be reported?
Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.
Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).
ReviewZ77
Documentation: The patient returns during the healing or recovery phase after active treatment of the same condition.
Coding question: Which 7th character applies?
Path: Review the official 7th-character definitions for this family in the 7th Character Guide.
Reason: “Initial encounter” means active treatment, not the first visit; care during recovery takes “subsequent encounter”, and a complication arising from the original condition takes “sequela” (Guidelines I.C.19.a).
Documentation: A condition the Use Additional Code note names is documented.
Coding question: Is a second code reported with T57.2X1D?
Path: Review the Use Additional Code note and the code it names.
Reason: The additional code is reported when the record documents the condition; a conditional instruction applies only when its condition is met (Guidelines I.A.13).
Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.
Code Overview
MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.
Associated Substances (1)
Official source data — entries quoted as published, in the Index’s own lookup phrasing
Substances from the official ICD-10-CM Table of Drugs and Chemicals that map to this code.
- Manganese (dioxide) (salts)
Decision Points
The directives on this code's own record, as a pre-claim checklist.
- A 7th character applies in this family. Confirm the documented encounter matches the character assigned. See the official 7th-character definitions and this code’s variants
- 4 Use Additional Code instructions — report the named additional code(s) when the documentation supports them. See the Use Additional Code notes
- 1 Excludes1 entry — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes
Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.
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
MedCoder structured relationships — computed from published CMS and AHRQ datasets
Other codes that name T57.2X1D 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.
Referenced by 11 Excludes2 notes across 2 chapters: T80 — Complications following infusion, transfusion and therapeutic injection (via T57.-), T80-T88 — Complications of surgical and medical care, not elsewhere classified (T80-T88) (via T57.-), T81 — Complications of procedures, not elsewhere classified (via T57.-), T82 — Complications of cardiac and vascular prosthetic devices, implants and grafts (via T57.-), T83 — Complications of genitourinary prosthetic devices, implants and grafts (via T57.-), T84 — Complications of internal orthopedic prosthetic devices, implants and grafts (via T57.-), T85 — Complications of other internal prosthetic devices, implants and grafts (via T57.-), T86 — Complications of transplanted organs and tissue (via T57.-), T87 — Complications peculiar to reattachment and amputation (via T57.-), T88 — Other complications of surgical and medical care, not elsewhere classified (via T57.-), Z77 — Other contact with and (suspected) exposures hazardous to health (via T57.-).
These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.
Referenced by 68 Code First instructions across 14 chapters: D61.2 — Aplastic anemia due to other external agents (via T57.-), D64.2 — Secondary sideroblastic anemia due to drugs and toxins (via T57.-), E03.2 — Hypothyroidism due to medicaments and other exogenous substances (via T57.-), E09 — Drug or chemical induced diabetes mellitus (via T57.-), F02 — Dementia in other diseases classified elsewhere (via T57.-), G21.2 — Secondary parkinsonism due to other external agents (via T57.-), G62.2 — Polyneuropathy due to other toxic agents (via T57.-), G70.1 — Toxic myoneural disorders (via T57.-), G72.2 — Myopathy due to other toxic agents (via T57.-), G92.8 — Other toxic encephalopathy (via T57.-), G92.9 — Unspecified toxic encephalopathy (via T57.-), H10.21 — Acute toxic conjunctivitis (via T57.-), H35.38 — Toxic maculopathy (via T57.-), H46.3 — Toxic optic neuropathy (via T57.-), H91.0 — Ototoxic hearing loss (via T57.-), I42.7 — Cardiomyopathy due to drug and external agent (via T57.-), J68 — Respiratory conditions due to inhalation of chemicals, gases, fumes and vapors (via T57.-), J69.1 — Pneumonitis due to inhalation of oils and essences (via T57.-), J69.8 — Pneumonitis due to inhalation of other solids and liquids (via T57.-), J70.8 — Respiratory conditions due to other specified external agents (via T57.-), +48 more.
Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.
MS-DRG Grouper Relationships (FY2026)
Potential MS-DRG participation — not a DRG assignment.
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 949 (MDC 23), DRG 950 (MDC 23).
From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.
Clinical classification (AHRQ CCSR):INJ060 — Toxic effects, subsequent encounter (default).
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.
T57.2X1A — Toxic effect of manganese and its compounds, accidental (unintentional), initial encounterCompare T57.2X1D vs T57.2X1A →, T57.2X1S — Toxic effect of manganese and its compounds, accidental (unintentional), sequela
Same clinical category (CCSR)
AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Toxic effects, subsequent encounter).
Contextual Map
Every relationship of T57.2X1D 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.
Run T57.2X1D with these 16 related codes in Claim Check
Hierarchy
- S00-T88 — Chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) (S00-T88)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- T51-T65 — Toxic effects of substances chiefly nonmedicinal as to source[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Referenced by Excludes2 notes (11)
- T80 — Complications following infusion, transfusion and therapeutic injection[Excludes2](via T57.-): “poisoning and toxic effects of drugs and chemicals (T36-T65 with fifth or sixth character 1-4 or 6)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- T80-T88 — Complications of surgical and medical care, not elsewhere classified (T80-T88)[Excludes2](via T57.-): “poisoning and toxic effects of drugs and chemicals (T36-T65 with fifth or sixth character 1-4 or 6)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- T81 — Complications of procedures, not elsewhere classified[Excludes2](via T57.-): “poisoning and toxic effects of drugs and chemicals (T36-T65 with fifth or sixth character 1-4)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- T82 — Complications of cardiac and vascular prosthetic devices, implants and grafts[Excludes2](via T57.-): “poisoning and toxic effects of drugs and chemicals (T36-T65 with fifth or sixth character 1-4 or 6)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- T83 — Complications of genitourinary prosthetic devices, implants and grafts[Excludes2](via T57.-): “poisoning and toxic effects of drugs and chemicals (T36-T65 with fifth or sixth character 1-4 or 6)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- T84 — Complications of internal orthopedic prosthetic devices, implants and grafts[Excludes2](via T57.-): “poisoning and toxic effects of drugs and chemicals (T36-T65 with fifth or sixth character 1-4 or 6)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- T85 — Complications of other internal prosthetic devices, implants and grafts[Excludes2](via T57.-): “poisoning and toxic effects of drugs and chemicals (T36-T65 with fifth or sixth character 1-4 or 6)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- T86 — Complications of transplanted organs and tissue[Excludes2](via T57.-): “poisoning and toxic effects of drugs and chemicals (T36-T65 with fifth or sixth character 1-4 or 6)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- and 3 more
Referenced by Code First instructions (68)
- D61.2 — Aplastic anemia due to other external agents[Code First](via T57.-): “, if applicable, toxic effects of substances chiefly nonmedicinal as to source (T51-T65)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- D64.2 — Secondary sideroblastic anemia due to drugs and toxins[Code First](via T57.-): “poisoning due to drug or toxin, if applicable (T36-T65 with fifth or sixth character 1-4)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- E03.2 — Hypothyroidism due to medicaments and other exogenous substances[Code First](via T57.-): “poisoning due to drug or toxin, if applicable (T36-T65 with fifth or sixth character 1-4)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- E09 — Drug or chemical induced diabetes mellitus[Code First](via T57.-): “poisoning due to drug or toxin, if applicable (T36-T65 with fifth or sixth character 1-4)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- F02 — Dementia in other diseases classified elsewhere[Code First](via T57.-): “intoxications (T36-T65)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- G21.2 — Secondary parkinsonism due to other external agents[Code First](via T57.-): “(T51-T65) to identify external agent”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- G62.2 — Polyneuropathy due to other toxic agents[Code First](via T57.-): “(T51-T65) to identify toxic agent”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- G70.1 — Toxic myoneural disorders[Code First](via T57.-): “(T51-T65) to identify toxic agent”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- and 60 more
Clinical classification (CCSR)
- INJ060 — Toxic effects, subsequent encounter[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)
MS-DRG Grouper
- DRG 949 — AFTERCARE WITH CC/MCC[MS-DRG]: “AFTERCARE WITH CC/MCC (MDC 23)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
- DRG 950 — AFTERCARE WITHOUT CC/MCC[MS-DRG]: “AFTERCARE WITHOUT CC/MCC (MDC 23)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
MDC crossing
- MDC 23 — Factors Influencing Health Status and Other Contacts with Health Services[MDC crossing]: “Factors Influencing Health Status and Other Contacts with Health Services — 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. 1,235 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026
Drugs & chemicals
- Manganese (dioxide) (salts) — Manganese (dioxide) (salts) — Poisoning, Accidental (unintentional) [Drug table]: “Manganese (dioxide) (salts) (Poisoning, Accidental (unintentional))”— CMS Table of Drugs and Chemicals · icd10cm-fy2026
Nearest codes (40)
- T57 — Toxic effect of other inorganic substances[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- T57.1X1 — Toxic effect of phosphorus and its compounds, accidental (unintentional)[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- T57.1X1A — Toxic effect of phosphorus and its compounds, accidental (unintentional), initial encounter[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- T57.1X1D — Toxic effect of phosphorus and its compounds, accidental (unintentional), subsequent encounter[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- T57.1X1S — Toxic effect of phosphorus and its compounds, accidental (unintentional), sequela[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- T57.1X2 — Toxic effect of phosphorus and its compounds, intentional self-harm[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- T57.1X2A — Toxic effect of phosphorus and its compounds, intentional self-harm, initial encounter[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- T57.1X2D — Toxic effect of phosphorus and its compounds, intentional self-harm, subsequent encounter[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- and 32 more
Change history
- FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016
Common coding questions
Does T57.2X1D require a 7th character?
Yes. The appropriate 7th character is to be added to each code from category T57.
Sources for this page
Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.
- Code, title, tabular notes and index terms Official source data
- CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
- Claim edits Official source data
- CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
- Inpatient payment groups Official source data
- CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page
- Change history and date-of-service validity Official source data
- CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
- Comparisons, relationships and the contextual map MedCoder structured relationship
- Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
- Summary and FAQ answers MedCoder explanation
- Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.
Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates
Change history
- FY2016 — October 1, 2015In the code set at ICD-10-CM adoptionToxic effect of manganese and its compounds, accidental (unintentional), subsequent encounter
No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to T57.2X1D in its code family, with their registry titles.
- T57.1X4S — Toxic effect of phosphorus and its compounds, undetermined, sequela
- T57.2 — Toxic effect of manganese and its compounds
- T57.2X — Toxic effect of manganese and its compounds
- T57.2X1 — Toxic effect of manganese and its compounds, accidental (unintentional)
- T57.2X1A — Toxic effect of manganese and its compounds, accidental (unintentional), initial encounter
- T57.2X1S — Toxic effect of manganese and its compounds, accidental (unintentional), sequela
- T57.2X2 — Toxic effect of manganese and its compounds, intentional self-harm
- T57.2X2A — Toxic effect of manganese and its compounds, intentional self-harm, initial encounter
- T57.2X2D — Toxic effect of manganese and its compounds, intentional self-harm, subsequent encounter
- T57.2X2S — Toxic effect of manganese and its compounds, intentional self-harm, sequela