Is ICD-10-CM code T63 billable?

No, T63 (Toxic effect of contact with venomous animals and plants) 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 T63 belong to?

T63 belongs to Chapter 19 of the ICD-10-CM tabular list: S00–T88 (Injury, Poisoning and Certain Other Consequences of External Causes).

T63Not billable, use a more specific code below

Toxic effect of contact with venomous animals and plants

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

456 billable codes under T63: none are a CC or MCC; 38 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

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

Excludes2: not included here, code separately if applicable

ingestion of toxic animal or plant (T61.-, T62.-)

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 T63.

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 T63
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.

Codes under T63

T63 can't be used on a claim. Pick a billable code below; grey headings group them.

T63 MS-DRGs

As the principal diagnosis, the billable codes under T63 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 (152 of 456 codes)
DRG 918 Poisoning and Toxic Effects of Drugs without MCC (152 of 456 codes)
DRG 922 Other Injury, Poisoning and Toxic Effect Diagnoses with MCC (152 of 456 codes)
DRG 923 Other Injury, Poisoning and Toxic Effect Diagnoses without MCC (152 of 456 codes)
DRG 949 Aftercare with CC/MCC (152 of 456 codes)
DRG 950 Aftercare without CC/MCC (152 of 456 codes)

Other codes that refer to T63

Notes on these codes point to T63.

S71 Excludes2: bite of venomous animal (T63.-)
W50-W64 Excludes1: Toxic effect of contact with venomous animals and plants (T63.-)
W56 Excludes1: contact with venomous marine animal (T63.-)
W64 Excludes1: contact with venomous animal (T63.-)

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

Animal Bites

Wild animals usually avoid people. They might attack, however, if they feel threatened, are sick, or are protecting their young or territory. Attacks by pets are more common. Animal bites rarely are life-threatening, but if they become infected, you can develop serious medical problems.

Code history

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