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ICD-10/T63.612A

T63.612A ICD-10-CM Code: Toxic effect of contact with Portuguese Man-o-war, intentional self-harm, 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.

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.

Official Registry Overview & Definition

Toxic effect of contact with Portuguese Man-o-war, intentional self-harm, initial encounter is a billable ICD-10-CM diagnosis code (T63.612A).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for T63.612A in the official ICD-10-CM tabular list.

Includes

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

  • bite or touch of venomous animal
  • pricked or stuck by thorn or leaf

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.

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.-)

Change history

  • FY2022 — 2021-10-01
    Description revised
    Toxic effect of contact with Portugese Man-o-war, intentional self-harm, initial encounter → Toxic effect of contact with Portuguese Man-o-war, intentional self-harm, initial encounter
    FY2022 changes
  • FY2022 — 2021-10-01
    Short description revised
    Toxic effect of contact w Portugese Man-o-war, slf-hrm, init → Toxic eff of cntct with Portuguese Man-o-war, slf-hrm, init
    FY2022 changes

Verify Before Coding

  • Billable — reportable as written.

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

Contextual Map

Every relationship of T63.612A 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]
  • T51-T65 — Toxic effects of substances chiefly nonmedicinal as to source [Hierarchy]

Referenced by Excludes1 notes (15)

  • W50 — Accidental hit, strike, kick, twist, bite or scratch by another person [Excludes1](via T63.-): “Toxic effect of contact with venomous animals and plants (T63.-)”
  • W50-W64 — Exposure to animate mechanical forces (W50-W64) [Excludes1](via T63.-): “Toxic effect of contact with venomous animals and plants (T63.-)”
  • W51 — Accidental striking against or bumped into by another person [Excludes1](via T63.-): “Toxic effect of contact with venomous animals and plants (T63.-)”
  • W52 — Crushed, pushed or stepped on by crowd or human stampede [Excludes1](via T63.-): “Toxic effect of contact with venomous animals and plants (T63.-)”
  • W53 — Contact with rodent [Excludes1](via T63.-): “Toxic effect of contact with venomous animals and plants (T63.-)”
  • W54 — Contact with dog [Excludes1](via T63.-): “Toxic effect of contact with venomous animals and plants (T63.-)”
  • W55 — Contact with other mammals [Excludes1](via T63.-): “Toxic effect of contact with venomous animals and plants (T63.-)”
  • W56 — Contact with nonvenomous marine animal [Excludes1](via T63.-): “contact with venomous marine animal (T63.-)”
  • and 7 more

Referenced by Excludes2 notes

  • S71 — Open wound of hip and thigh [Excludes2](via T63.-): “bite of venomous animal (T63.-)”

Clinical classification (CCSR)

  • MBD012 — Suicidal ideation/attempt/intentional self-harm [CCSR]
  • EXT012 — External cause codes: bites; initial encounter [CCSR]
  • EXT021 — External cause codes: intent of injury, self-harm [CCSR]
  • INJ023 — Toxic effects, initial encounter [CCSR]

Risk adjustment (CMS-HCC)

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

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)”

Nearest codes (40)

  • T63 — Toxic effect of contact with venomous animals and plants [Sibling]
  • T63.591S — Toxic effect of contact with other venomous fish, accidental (unintentional), sequela [Sibling]
  • T63.592 — Toxic effect of contact with other venomous fish, intentional self-harm [Sibling]
  • T63.592A — Toxic effect of contact with other venomous fish, intentional self-harm, initial encounter [Sibling]
  • T63.592D — Toxic effect of contact with other venomous fish, intentional self-harm, subsequent encounter [Sibling]
  • T63.592S — Toxic effect of contact with other venomous fish, intentional self-harm, sequela [Sibling]
  • T63.593 — Toxic effect of contact with other venomous fish, assault [Sibling]
  • T63.593A — Toxic effect of contact with other venomous fish, assault, initial encounter [Sibling]
  • and 32 more

Change history (2)

  • FY2022 — Description revised [Change history]
  • and 1 more

Referenced by Other Codes

Clinical classification (AHRQ CCSR):MBD012 — Suicidal ideation/attempt/intentional self-harm (default); EXT012 — External cause codes: bites; initial encounter; 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.

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.

Official ICD-10-CM tabular notes on other codes that name T63.612A or its code family.

15 Excludes1 notes: W50 (via T63.-), W50-W64 (via T63.-), W51 (via T63.-), W52 (via T63.-), W53 (via T63.-), W54 (via T63.-), W55 (via T63.-), W56 (via T63.-), W57 (via T63.-), W58 (via T63.-) and 5 more.

1 Excludes2 notes: S71 (via T63.-).

Frequently Asked Questions (FAQ) & Clinical Guidance

Does T63.612A require a 7th character?

Yes. The appropriate 7th character is to be added to each code from category T63.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to T63.612A in its code family, with their registry titles.

  • T63.611 — Toxic effect of contact with Portuguese Man-o-war, accidental (unintentional)
  • T63.611A — Toxic effect of contact with Portuguese Man-o-war, accidental (unintentional), initial encounter
  • T63.611D — Toxic effect of contact with Portuguese Man-o-war, accidental (unintentional), subsequent encounter
  • T63.611S — Toxic effect of contact with Portuguese Man-o-war, accidental (unintentional), sequela
  • T63.612 — Toxic effect of contact with Portuguese Man-o-war, intentional self-harm
  • T63.612D — Toxic effect of contact with Portuguese Man-o-war, intentional self-harm, subsequent encounter
  • T63.612S — Toxic effect of contact with Portuguese Man-o-war, intentional self-harm, sequela
  • T63.613 — Toxic effect of contact with Portuguese Man-o-war, assault
  • T63.613A — Toxic effect of contact with Portuguese Man-o-war, assault, initial encounter
  • T63.613D — Toxic effect of contact with Portuguese Man-o-war, assault, subsequent encounter

View all codes in the T63 family