ICD-10 Code T44.902D: Poisoning by unspecified ANS drugs

Key takeaways

T44.902D is a billable ICD-10-CM code for poisoning by unspecified autonomic nervous system drugs, intentional self-harm, subsequent encounter.

The seventh character D marks a subsequent encounter, so use T44.902A for initial visits and T44.902S for sequela visits.

Sequence the resulting condition first, then T44.902D, then an additional code for any associated mental health condition.

Documentation has to name the substance, the intent, and the phase of care for this specific visit.

Practice management software like Pabau tracks each claim’s status after submission, so a denial tied to the wrong seventh character surfaces fast.

ICD-10 Code T44.902D is a billable code for poisoning by unspecified drugs that primarily affect the autonomic nervous system. The manner is intentional self-harm, and the seventh character D places the visit at a subsequent encounter. That means the patient has already had active treatment and is now in the healing or recovery phase.

T44.902D took effect October 1, 2025, under the 2026 edition of ICD-10-CM. This reference covers the full descriptor, billable status, and the T44 hierarchy. It also walks through the encounter-type characters, the sequencing rules, the documentation standards an auditor expects, and the codes coders reach for alongside T44.902D.

ICD-10 Code T44.902D: Full description and billable status

T44.902D is confirmed billable for the 2026 ICD-10-CM edition. Coders can use it directly on claims without selecting a more specific child code.

Because T44.902D sits at the fully specified sixth-character level with a seventh-character encounter type, no further hierarchy selection is needed. Coders using the CDC ICD-10-CM tool will find T44.902D listed as valid and billable under the 2026 tabular list.

Code classification and hierarchy

Knowing where T44.902D sits in the hierarchy keeps coders from defaulting to a non-billable parent code. The same trap catches codes like T86.832, where the billable code sits below a subcategory that looks complete on its own.

The T44 category covers nine drug subcategories, T44.0 through T44.8, before reaching the unspecified group at T44.9. T44.902D belongs to that unspecified group, meaning the drug involved is not classifiable to a more specific T44 subcategory. Per the CMS ICD-10 codes page, coders should always use the most specific code available. T44.902D applies only when the drug cannot be identified or falls outside the defined subcategories.

Understanding the seventh character: subsequent encounter (D)

The seventh character is the single most consequential digit in T44.902D. Applying the wrong character on a claim can misrepresent the nature of the encounter and invite a medical necessity review.

The ICD-10-CM Official Guidelines distinguish initial from subsequent by the nature of treatment, not by calendar sequence. A patient can have several initial encounters if they receive active treatment at more than one facility. Once treatment shifts to wound management, monitoring, or rehabilitation, D is correct.

Only three seventh characters apply to poisoning codes: A for initial, D for subsequent, and S for sequela. Other injury categories run a longer set, which is how S02.651K marks a fracture that healed into nonunion.

T44.902A, T44.902D, and T44.902S: encounter type comparison

All three T44.902 variants describe the same event: poisoning by unspecified ANS drugs with self-harm intent. The seventh character is the only difference between them. The same A, D, and S framework runs through the injury chapter, which is how S06.813S flags a lasting brain injury.

• T44.902A (initial encounter): Use for the first visit where active poisoning management happens. That covers emergency department stabilization, gastric lavage, activated charcoal, or the first inpatient admission for the episode.
• T44.902D (subsequent encounter): Use for follow-up visits during the healing phase. Examples include outpatient psychiatric follow-up after medical stabilization, wound care for ingestion-related tissue damage, or routine labs during recovery.
• T44.902S (sequela): Use when documenting a complication that is a direct consequence of the original poisoning. The sequela code identifies the nature of the late effect, and T44.902S identifies the originating cause. Sequence the sequela condition first, then T44.902S.

Coding editors reviewing inpatient records look for consistency between the seventh character and the clinical activity documented for that visit. A note describing discharge planning and psychiatric medication adjustment supports D. A note describing activated charcoal and telemetry monitoring supports A.

Coding guidelines for intentional self-harm poisoning

ICD-10-CM treats poisoning by intentional self-harm as a combination code with its own sequencing rules. Applying them out of order is one of the most flagged errors in poisoning claim audits.

The AAPC Codify ICD-10-CM reference and the official CMS guidelines both require this sequence for intentional self-harm poisoning encounters:

1. Code the resulting condition first. The injury, organ damage, or clinical manifestation caused by the poisoning is the principal diagnosis. Examples include acute respiratory failure, cardiac arrhythmia, and altered mental status.
2. Code T44.902D second. The poisoning code carries the substance category and the manner of poisoning. Here that is the unspecified ANS drug group, with intentional self-harm as the manner.
3. Use an additional code for the associated mental health condition. If the note documents an underlying diagnosis such as depression or borderline personality disorder, code it separately with the appropriate F-chapter code. The guidelines are explicit that an additional code should identify any associated mental disorder.

Do not use T44.902D alone when the patient presents with a clinical consequence of the poisoning. The sequencing rule exists because payers need the primary reason for the encounter, not just the toxic exposure. A structured mental state examination in the note is what makes the F-chapter code defensible.

Practices running mental health practice management platforms can build these sequencing requirements into their documentation templates. That takes the rework off the coder and out of the query queue.

Documentation requirements for T44.902D

T44.902D is only as defensible as the note behind it. Auditors read the encounter documentation to confirm the manner of poisoning and the phase of care, so both have to be stated rather than implied.

• Substance and route: Name the drug or drug class where it is known, plus the route and the approximate amount. Say explicitly when the substance was unidentified, because that statement is what justifies the unspecified code.
• Intent: The record needs a clear statement that the poisoning was self-inflicted. Intent drives the sixth character, so a note that only says overdose does not support T44.902D.
• Phase of care: Describe what the provider actually did at this visit. Wound checks, medication adjustment, and recovery monitoring support D, while stabilization and decontamination support A.
• Resulting condition: Document the manifestation that brought the patient in, because that condition is sequenced first. Without it, T44.902D lands alone on the claim and reads as incomplete to the payer.
• Associated mental health condition: Record the psychiatric diagnosis under treatment, along with the current risk assessment. That is what supports the additional F-chapter code.

Practices that see these patients through recovery usually capture the psychiatric side on a structured form rather than in free text. A suicide safety plan stored on the patient record shows the risk work that followed the poisoning event. Psychiatry practice software keeps that form beside the coder’s view of the chart.

One more habit saves queries later. Restate the encounter phase in the plan at every visit in the episode. That way the seventh character never has to be inferred from the order of the notes.

Drugs primarily affecting the autonomic nervous system: what T44.902D covers

The T44 category covers poisoning by drugs that act on the autonomic nervous system. T44.902D is the unspecified variant. The drug is either not identified, or it does not fit a more specific T44 subcategory. Use the specific code whenever the drug is known.

When a patient ingests several substances and one of them is a specific ANS drug, use that drug’s T44 subcategory rather than T44.902D. The unspecified designation is appropriate only when documentation does not support a finer classification. Keep it separate from an autonomic disorder diagnosis such as G90.A, which describes dysfunction rather than poisoning.

Present on admission (POA) status for T44.902D

T44.902D is typically POA exempt. Because it carries the seventh character D, the poisoning event itself happened before the current encounter. POA reporting applies to inpatient admissions and records whether a condition was present on arrival.

• POA exempt status: Subsequent encounter codes are generally exempt from POA reporting, because the condition that prompted the visit preceded the current admission.
• Practical impact: Coders do not assign a POA indicator of Y, N, W, or U for T44.902D on UB-04 inpatient claims. Confirm against the current CMS POA exempt list for fiscal year 2026 before you finalize.
• Outpatient claims: POA reporting does not apply in outpatient settings. T44.902D may be used on outpatient claims without a POA indicator, whatever its exempt status.

Practices that keep HIPAA-compliant clinical documentation can automate POA logic by building encounter-type rules into the billing workflow. That cuts the manual checks on codes like T44.902D, where exempt status hangs on the seventh character.

POA exempt status behaves the same way across the injury and poisoning chapter. The logic you apply to T44.902D carries to the rest of the T36-T50 block. What changes from claim to claim is the seventh character, which is why the submitted claim is worth tracking.

Related ICD-10 codes to know alongside T44.902D

Coders working with T44.902D meet several adjacent codes in practice. Knowing which one applies in each scenario prevents downcoding and avoids payer queries.

What separates T44.902D from T50.902D is the drug category, not the intent or the encounter type. T44.902D is restricted to autonomic nervous system drugs. T50.902D covers unspecified drugs and biological substances more broadly. Check the full T44 subcategory list in the tabular index before you settle on either one.

Cross-code selection also matters for reimbursement. Payers reviewing poisoning claims may compare the coded substance category against discharge summaries and toxicology reports. Practices using patient record documentation with structured substance fields make that cross-check quick for coders and auditors.

How Pabau supports ICD-10 coding for poisoning encounters

Practices coding encounters like T44.902D run into the same three problems. The substance is described loosely in the note, and the F-chapter diagnosis never makes it onto the claim. On top of that, the seventh character drifts across a multi-visit episode. Each one raises the odds of a denial.

Practice management software like Pabau closes that loop at the point of care. Its digital intake and clinical forms can carry structured fields for the substance, the intent, and the encounter phase. The coder then reads a complete record instead of a narrative that needs a provider query.

• Structured clinical documentation: Fields for substance, intent, and encounter phase cut the narrative ambiguity in the note. That ambiguity is what pushes coders toward an unspecified code when a specific one exists.
• Claim status tracking: Pabau’s claims management software shows where every submitted claim sits, from pending through to paid or error. A rejection tied to the wrong seventh character surfaces in the screen your team already works from.
• Billing continuity across visits: The patient record links clinical notes to billing records from the initial encounter onward. That makes the A-to-D move visible to whoever bills the follow-up, including short nurse visits billed as CPT code 99211.

Getting T44.902D right comes down to four things: intent, encounter type, sequencing, and the associated diagnosis. Structured documentation captures all four during the visit, instead of reconstructing them once the claim is already out.

Keep poisoning claims moving without rework

Pabau captures substance, intent, and encounter phase on the clinical form, then tracks each claim's status after submission. Your coders stop chasing notes and your billers see rejections early.

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Conclusion

The hard part of T44.902D is not finding the code. It is proving, in the note, that this visit was recovery care for a self-inflicted poisoning.

Fix the documentation and the coding follows. When the substance, intent, phase of care, and psychiatric diagnosis all sit in the record, the seventh character stops being a judgment call.

The trade-off worth remembering is specificity. T44.902D is legitimate when the substance genuinely cannot be identified, and a liability when the chart could have named it. Book a demo to see how Pabau keeps substance, intent, and encounter phase on the record your coders read.

Continue your research

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