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ICD-10/T67.09XA

T67.09XA ICD-10-CM Code: Other heatstroke and sunstroke, 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 922 — OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC (MDC 21)
  • MS-DRG 923 — OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES 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

Other heatstroke and sunstroke, initial encounter is a billable ICD-10-CM diagnosis code (T67.09A).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for T67.09XA in the official ICD-10-CM tabular list.

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.

Code Also

Additional codes that may be required to fully describe the encounter.

  • Code also, if applicable, place of occurrence, such as:
  • highway rest stop (Y92.523)
  • school (private) (public) (state) as the place of occurrence of the external cause (Y92.21-)
  • service areas as the place of occurrence of the external cause (Y92.52-)
  • single-family non-institutional (private) house as the place of occurrence of the external cause (Y92.01-)
  • transport vehicle as the place of occurrence of the external cause (Y92.81-)

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code(s) to identify any associated complications of heatstroke, such as:
  • coma and stupor (R40.-)
  • rhabdomyolysis (M62.82)
  • systemic inflammatory response syndrome (R65.1-)

Change history

  • FY2020 — 2019-10-01
    Added to the code set
    Other heatstroke and sunstroke, initial encounter
    FY2020 changes

Verify Before Coding

  • Billable — reportable as written.
  • CC as a secondary diagnosis (FY2026). Can raise the stay's MS-DRG severity tier.

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 T67.09XA 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

  • T67.09 — Other heatstroke and sunstroke [Hierarchy]

Referenced by Excludes1 notes

  • R53.8 — Other malaise and fatigue [Excludes1](via T67.-): “exhaustion and fatigue due to heat (T67.-)”

Referenced by Code First instructions

  • R65.1 — Systemic inflammatory response syndrome (SIRS) of non-infectious origin [Code First](via T67.0.-): “heatstroke (T67.0-)”

Clinical classification (CCSR)

  • INJ021 — Effect of other external causes, initial encounter [CCSR]

Potential MS-DRG

  • CC — Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (CC).”
  • DRG 922 — OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC [MS-DRG]: “OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC (MDC 21)”
  • DRG 923 — OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC [MS-DRG]: “OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC (MDC 21)”

Nearest codes (40)

  • T67 — Effects of heat and light [Sibling]
  • T67.0 — Heatstroke and sunstroke [Sibling]
  • T67.01 — Heatstroke and sunstroke [Sibling]
  • T67.01XA — Heatstroke and sunstroke, initial encounter [Sibling]
  • T67.01XD — Heatstroke and sunstroke, subsequent encounter [Sibling]
  • T67.01XS — Heatstroke and sunstroke, sequela [Sibling]
  • T67.02 — Exertional heatstroke [Sibling]
  • T67.02XA — Exertional heatstroke, initial encounter [Sibling]
  • and 32 more

Change history

  • FY2020 — Added to the code set [Change history]

Referenced by Other Codes

Clinical classification (AHRQ CCSR):INJ021 — Effect of other external causes, initial encounter (default).

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)

CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 12 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 2 MS-DRGs: DRG 922 (MDC 21), DRG 923 (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 T67.09XA or its code family.

1 Excludes1 notes: R53.8 (via T67.-).

1 Code First instructions: R65.1 (via T67.0.-).

Frequently Asked Questions (FAQ) & Clinical Guidance

Does T67.09XA require a 7th character?

Yes. The appropriate 7th character is to be added to each code from category T67.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to T67.09XA in its code family, with their registry titles.

  • T67.02 — Exertional heatstroke
  • T67.02XA — Exertional heatstroke, initial encounter
  • T67.02XD — Exertional heatstroke, subsequent encounter
  • T67.02XS — Exertional heatstroke, sequela
  • T67.09 — Other heatstroke and sunstroke
  • T67.09XD — Other heatstroke and sunstroke, subsequent encounter
  • T67.09XS — Other heatstroke and sunstroke, sequela
  • T67.1 — Heat syncope
  • T67.1XXA — Heat syncope, initial encounter
  • T67.1XXD — Heat syncope, subsequent encounter

View all codes in the T67 family