Is ICD-10-CM code T56 billable?

No, T56 (Toxic effect of metals) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code T56 belong to?

T56 belongs to Chapter 19 of the ICD-10-CM tabular list: S00–T88 (Injury, Poisoning and Certain Other Consequences of External Causes).

T56Not billable, use a more specific code below

Toxic effect of metals

In Toxic effects of substances chiefly nonmedicinal as to source (T51-T65), chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes

144 billable codes under T56: none are a CC or MCC; 12 map to HCC 155 (Major Depression, Moderate or Severe, without Psychosis).An HCC counts toward a Medicare Advantage patient's risk score.

Instructional notes

Includes: conditions that are coded here

toxic effects of fumes and vapors of metals
toxic effects of metals from all sources, except medicinal substances

Excludes1: not coded here, use a different code

arsenic and its compounds (T57.0)
manganese and its compounds (T57.2)

Use additional code: add a second code for this, listed after this one

code to identify any retained metal foreign body, if applicable (Z18.0-, T18.1-)

Also applies, from Toxic effects of substances chiefly nonmedicinal as to source (T51-T65)

These notes sit on T51-T65 and apply to every code under it, including T56.

Excludes1: not coded here, use a different code

contact with and (suspected) exposure to toxic substances (Z77.-)

Use additional code: add a second code for this, listed after this one

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.-)

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

Section I.C.19.e Adverse Effects, Poisoning, Underdosing and Toxic Effects (page 82), covers T56
For adverse effects, code the effect first, then T36-T50 with character 5. Sequence poisonings (unknown intent coded accidental) and toxic effects (T51-T65) first; underdosing (character 6) is never first-listed.

All codes under T56

T56 can't be used on a claim. Pick a billable code below; grey headings group them.

T56 MS-DRGs

As the principal diagnosis, the billable codes under T56 group to MS-DRG 917, 918, 922, 923, 949, or 950 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 917 Poisoning and Toxic Effects of Drugs with MCC (48 of 144 codes)
DRG 918 Poisoning and Toxic Effects of Drugs without MCC (48 of 144 codes)
DRG 922 Other Injury, Poisoning and Toxic Effect Diagnoses with MCC (48 of 144 codes)
DRG 923 Other Injury, Poisoning and Toxic Effect Diagnoses without MCC (48 of 144 codes)
DRG 949 Aftercare with CC/MCC (48 of 144 codes)
DRG 950 Aftercare without CC/MCC (48 of 144 codes)

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.