Skip to main content

T57.92XA ICD-10-CM Code: Toxic effect of unspecified inorganic substance, intentional self-harm, initial 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 Excludes1 · 4 use-additional codes
Risk adjustment
CMS-HCC V28: 1 category · CMS-HCC V22 category 58 · RxHCC V08 category 132

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 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.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 155 — Major Depression, Moderate or Severe, without Psychosis

Other models: CMS-HCC V22 HCC 58 · RxHCC V08 HCC 132

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for T57.92XA in the official ICD-10-CM tabular list, quoted as published.

Notes without a marker are published on T57.92XA itself; “inherited from” names the category or block whose note applies here.

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).

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 (this page’s code)
  • D — subsequent encounter
  • 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

T57.92XA, T57.92XD, T57.92XS

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.

Code Overview

Toxic effect of unspecified inorganic substance, intentional self-harm, initial encounter is a billable ICD-10-CM diagnosis code (T57.92XA).

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

Decision Points

The directives on this code's own record, as a pre-claim checklist.

  1. 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
  2. 4 Use Additional Code instructions — report the named additional code(s) when the documentation supports them. See the Use Additional Code notes
  3. 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

Other codes that name T57.92XA 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)

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

Potential MS-DRG participation — not a DRG assignment.

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):MBD012 — Suicidal ideation/attempt/intentional self-harm (default); EXT015 — External cause codes: poisoning by non-drug; EXT021 — External cause codes: intent of injury, self-harm; INJ023 — Toxic effects, initial encounter.

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.

T57.92XD — Toxic effect of unspecified inorganic substance, intentional self-harm, subsequent encounterCompare T57.92XA vs T57.92XD →, T57.92XS — Toxic effect of unspecified inorganic substance, intentional self-harm, sequelaCompare T57.92XA vs T57.92XS →

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Major Depression, Moderate or Severe, without Psychosis) for risk-adjusted payment.

T56.7X2A — Toxic effect of beryllium and its compounds, intentional self-harm, initial encounter, T56.812A — Toxic effect of thallium, intentional self-harm, initial encounter, T56.822A — Toxic effect of gadolinium, intentional self-harm, initial encounter, T56.892A — Toxic effect of other metals, intentional self-harm, initial encounter, T56.92XA — Toxic effect of unspecified metal, intentional self-harm, initial encounter, T57.0X2A — Toxic effect of arsenic and its compounds, intentional self-harm, initial encounter, T57.1X2A — Toxic effect of phosphorus and its compounds, intentional self-harm, initial encounter, T57.2X2A — Toxic effect of manganese and its compounds, intentional self-harm, initial encounter, T57.3X2A — Toxic effect of hydrogen cyanide, intentional self-harm, initial encounter, T57.8X2A — Toxic effect of other specified inorganic substances, intentional self-harm, initial encounter, T58.02XA — Toxic effect of carbon monoxide from motor vehicle exhaust, intentional self-harm, initial encounter, T58.12XA — Toxic effect of carbon monoxide from utility gas, intentional self-harm, initial encounter, T58.2X2A — Toxic effect of carbon monoxide from incomplete combustion of other domestic fuels, intentional self-harm, initial encounter, T58.8X2A — Toxic effect of carbon monoxide from other source, intentional self-harm, initial encounter, T58.92XA — Toxic effect of carbon monoxide from unspecified source, intentional self-harm, initial encounter, T59.0X2A — Toxic effect of nitrogen oxides, intentional self-harm, initial encounter, T59.1X2A — Toxic effect of sulfur dioxide, intentional self-harm, initial encounter, T59.2X2A — Toxic effect of formaldehyde, intentional self-harm, initial encounter, T59.3X2A — Toxic effect of lacrimogenic gas, intentional self-harm, initial encounter, T59.4X2A — Toxic effect of chlorine gas, intentional self-harm, initial encounter, +350 more

Related risk categories

These categories interact through CMS's HCC hierarchy — one can suppress the other's risk-adjustment weight when both are present on a claim.

Schizophrenia, Psychosis, Except Schizophrenia, Personality Disorders; Anorexia/Bulimia Nervosa, Bipolar Disorders without Psychosis

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical categories (Suicidal ideation/attempt/intentional self-harm, External cause codes: poisoning by non-drug, External cause codes: intent of injury, self-harm, Toxic effects, initial encounter).

+795 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.

Prothrombin Time Test and INR (PT/INR)

Contextual Map

Every relationship of T57.92XA 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 T57.92XA with these 16 related codes in Claim Check

Hierarchy

Referenced by Excludes2 notes (11)

Referenced by Code First instructions (68)

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

  • HCC 155 — Major Depression, Moderate or Severe, without Psychosis [CMS-HCC]— CMS-HCC V28 · 2026

MS-DRG Grouper

MDC crossing

  • 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. 32,029 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Nearest codes (40)

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 T57.92XA 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
Risk adjustment Official source data
2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release 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, 2015
    In the code set at ICD-10-CM adoption
    Toxic effect of unspecified inorganic substance, intentional self-harm, initial 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 T57.92XA in its code family, with their registry titles.

View all codes in the T57 family