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T65.93XD ICD-10-CM Code: Toxic effect of unspecified substance, assault, 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 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 v43.0, Appendix B.

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 T65.93XD in the official ICD-10-CM tabular list, quoted as published.

Notes without a marker are published on T65.93XD 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 T65"

  • 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

T65.93XA, T65.93XD, T65.93XS

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 substance, assault, subsequent encounter is a billable ICD-10-CM diagnosis code (T65.93XD).

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

Official Coding Guidelines

Verbatim excerpts from the ICD-10-CM Official Guidelines for Coding and Reporting (CMS/NCHS) that govern this code.

Chapter 19: Injury, poisoning, and certain other consequences of external causes (S00-T88)

e. Adverse Effects, Poisoning, Underdosing and Toxic Effects Codes in categories T36-T65 are combination codes that include the substance that was taken as well as the intent. No additional external cause code is required for poisonings, toxic effects, adverse effects and underdosing codes.

Chapter 19: Injury, poisoning, and certain other consequences of external causes (S00-T88)

(d) Toxic Effects W hen a harmful substance is ingested or comes in contact with a person, this is classified as a toxic effect. The toxic effect codes are in categories T51-T65. When coding a toxic effect, assign the toxic effect code first, followed by codes for all associated manifestations of the toxic effect.

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 T65.93XD 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 T65.-), T80-T88 — Complications of surgical and medical care, not elsewhere classified (T80-T88) (via T65.-), T81 — Complications of procedures, not elsewhere classified (via T65.-), T82 — Complications of cardiac and vascular prosthetic devices, implants and grafts (via T65.-), T83 — Complications of genitourinary prosthetic devices, implants and grafts (via T65.-), T84 — Complications of internal orthopedic prosthetic devices, implants and grafts (via T65.-), T85 — Complications of other internal prosthetic devices, implants and grafts (via T65.-), T86 — Complications of transplanted organs and tissue (via T65.-), T87 — Complications peculiar to reattachment and amputation (via T65.-), T88 — Other complications of surgical and medical care, not elsewhere classified (via T65.-), Z77 — Other contact with and (suspected) exposures hazardous to health (via T65.-).

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 T65.-), D64.2 — Secondary sideroblastic anemia due to drugs and toxins (via T65.-), E03.2 — Hypothyroidism due to medicaments and other exogenous substances (via T65.-), E09 — Drug or chemical induced diabetes mellitus (via T65.-), F02 — Dementia in other diseases classified elsewhere (via T65.-), G21.2 — Secondary parkinsonism due to other external agents (via T65.-), G62.2 — Polyneuropathy due to other toxic agents (via T65.-), G70.1 — Toxic myoneural disorders (via T65.-), G72.2 — Myopathy due to other toxic agents (via T65.-), G92.8 — Other toxic encephalopathy (via T65.-), G92.9 — Unspecified toxic encephalopathy (via T65.-), H10.21 — Acute toxic conjunctivitis (via T65.-), H35.38 — Toxic maculopathy (via T65.-), H46.3 — Toxic optic neuropathy (via T65.-), H91.0 — Ototoxic hearing loss (via T65.-), I42.7 — Cardiomyopathy due to drug and external agent (via T65.-), J68 — Respiratory conditions due to inhalation of chemicals, gases, fumes and vapors (via T65.-), J69.1 — Pneumonitis due to inhalation of oils and essences (via T65.-), J69.8 — Pneumonitis due to inhalation of other solids and liquids (via T65.-), J70.8 — Respiratory conditions due to other specified external agents (via T65.-), +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 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.

T65.93XA — Toxic effect of unspecified substance, assault, initial encounterCompare T65.93XD vs T65.93XA →, T65.93XS — Toxic effect of unspecified substance, assault, sequela

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Toxic effects, subsequent encounter).

+543 more

Contextual Map

Every relationship of T65.93XD 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

Referenced by Excludes2 notes (11)

Referenced by Code First instructions (68)

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

Nearest codes (40)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]

Common coding questions

Does T65.93XD require a 7th character?

Yes. The appropriate 7th character is to be added to each code from category T65.

Sources for this page

Every coding fact on this page is read from the datasets below. Nothing is AI-generated; MedCoder-derived relationships and editorial are labelled where they appear.

Code, title, tabular notes and index terms
CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025
Coding guidelines
ICD-10-CM Official Guidelines for Coding and Reporting (FY2026), quoted by section
Claim edits
CMS Definitions of Medicare Code Edits — v43.1 (April 2026)
Inpatient payment groups
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
Change history and date-of-service validity
CMS ICD-10-CM release addenda, ingested release by release into the change ledger
Comparisons, relationships and the contextual map MedCoder-derived
Derived by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears

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 substance, assault, 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 T65.93XD in its code family, with their registry titles.

View all codes in the T65 family