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| | ICD10 Code=T45.1 | | | ICD10 Code=T45.1 |
| | BugRequired= | | | BugRequired= |
| | | StartDate=2018-11-25 |
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| {{ICD10 category|Iatrogenic}}{{ICD10 category|Poisoning by non-pharmaceuticals}}{{ICD10 category|Neoplastic}} | | {{ICD10 category|Iatrogenic}}{{ICD10 category|Overdose}}{{ICD10 category|Neoplastic}} |
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| == Additional Info == | | == Additional Info == |
| {{ICD10 Guideline drugs and substances}} | | Inlcudes: antirejection drugs |
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| | {{List of immunosuppressive drugs}} |
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| {{ICD10 Guideline overdose}} | | {{ICD10 Guideline overdose}} |
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| == Alternate ICD10s to consider coding instead or in addition == | | == Alternate ICD10s to consider coding instead or in addition == |
| | * [[Past history of immunosuppressive drugs or corticosteroids]] |
| {{ListICD10Category | categoryName = Overdose}} | | {{ListICD10Category | categoryName = Overdose}} |
| {{ListICD10Category | categoryName = Adverse effect}} | | {{ListICD10Category | categoryName = Adverse effect}} |
This diagnosis is a part of ICD10 collection.
- SMW
- 2018-11-25
- 2999-12-31
- T45.1
Additional Info
Inlcudes: antirejection drugs
| List of immunosuppressive drugs
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- Used to treat an increasing variety of conditions: immune-mediated (RA, UC, Crohn's, lupus, MS, psoriasis, etc); after organ transplant.
- Only considered immunosuppressive if given systemically (po, im or iv)
- Corticosteroids (unlike all the others, these only count if > a given daily dose and used for at least 2 weeks prior to admission)
- Dexamethasone: >0.25 mg/day
- Hydrocortisone: >40 mg/day
- Prednisone (methyl-prednisolone): >10 mg/day
- Prednisolone: >8 mg/day
- Cancer chemotherapy -- includes any agents, if received within the past 6 months
- Nonsteroidal immunosuppressives -- includes any of these, if received within the past 1 month
- Abatacept (Orencia)
- Azathioprine (Imuran)
- Adalimumab (Humira)
- Anakinra (Kineret)
- Basiliximab (Simulect)
- Certolizumab (Cimzia)
- Cyclophosphamide (Cytoxan)
- Cyclosporine
- Daclizumab (Zinbryta)
- Etanercept (Enbrel)
- Everolimus (Afinitor, Zortress)
- Golimumag (Simponi)
- Infliximab (Remicade)
- Ixekizumab (Taltz)
- Leflunomide (Arava)
- Lenalidomide
- Methotrexate
- Mycophenolate (CellCept)
- Natalizumab (Tysabri)
- Rituximab (Rituxan)
- Secukinumab (Cosentyx)
- Sirolimus (Rapasumne)
- Tacrolimus (Prograf)
- Tocilizumab (Actemra)
- Tofacitinib (Xeljanz)
- Ustekinumab (Stelara)
- Vedolizumab (Entyvio)
Do not include
- hydroxychloroquine - as per task meeting 2022-04-20 it is an immune modulator, but not very immunosuppressive
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Overdose/toxicity codes
- This category is in relation to pharmaceuticals and other biological substances (as opposed to Category:Poisoning by non-pharmaceuticals)
- To qualify for these codes, there must be a threat to life, or limb, or to functioning for one or more organs AND there was an INAPPROPRIATE dosing regimen -- thus the threat was a consequence of an overdose
- e.g. opioid overdose can cause respiratory arrest or shock, both of which can be life threats
- e.g. acetominophen overdose puts the liver at risk of failing
- There is no assumption here about whether the overdose was accidental or not -- if it was a suicide attempt, then you should link the overdose code with Suicide attempt (intentional self-harm)
- In addition to a number of codes for specific agents (e.g. insulin), or classes of agents (e.g. beta-blockers) there are several levels of “wastebasket” codes -- the final, all-encompassing wastebasket here is Drug or biological substance/agent NOS, overdose/toxicity
Overdose/toxicity codes are to be used for drugs that have been used at an inappropriate dose or frequency, or in a recreational /non-prescription use setting.
For bad outcomes caused by drugs that had been used appropriately, in most cases a counterpart dx will exits in:
how to use
- People are admitted for an overdose for either of 2 possible scenarios:
- (1) Nothing bad has happened to them yet, but it may and so they're admitted for observation. In this case, the Primary Admit Diagnosis would be Observation for SUSPECTED overdose, and this should be combined with the specific drug(s) in the overdose -- and IF it was a suicide attempt than also combine with Suicide attempt
- (2) They HAVE dangerous physiologic manifestations already (e.g. resp failure, shock) and the admission is for that/those manifestations. In this case you should combine all the manifestations present + the overdose(s) and if relevant also Suicide attempt (intentional self-harm). And in this case, the Primary Admit Diagnosis is the ONE of the physiologic manifestations which is most responsible for the admission (i.e. "worst"; just like we do when people present with infection and multiple organ failures, we choose the worst manifestation as primary).
Coding substance related ICD10 diagnoses
See ICD10 Guideline for drugs and substances for more info on coding substance related ICD10 diagnoses.
Alternate ICD10s to consider coding instead or in addition
Related CCI Codes
none found
Related Articles
| Related articles:
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- Combined ICD10 codes (← links)
- Hallucinogen, acute intoxication (← links)
- Lip or mouth or tonsils or pharynx, primary malignancy (← links)
- Heart, primary malignancy (← links)
- Mediastinum, primary malignancy (← links)
- Nerves, peripheral or autonomic, primary malignancy (← links)
- Lymph nodes, metastatic malignancy to them (also code primary site) (← links)
- Lung, metastatic malignancy to it (also code primary site) (← links)
- Pleura, metastatic malignancy to it (also code primary site) (← links)
- Respiratory system NOS, metastatic malignancy to it (also code primary site) (← links)
- Peritoneum, metastatic malignancy to it (also code primary site) (← links)
- Liver or biliary system, metastatic malignancy to it (also code primary site) (← links)
- Gastrointestinal system NOS, metastatic malignancy to it (also code primary site) (← links)
- Urinary system NOS, metastatic malignancy to it (also code primary site) (← links)
- Brain or meninges, metastatic malignancy to it (also code primary site) (← links)
- Bone or bone marrow, metastatic malignancy to it (also code primary site) (← links)
- Adrenal gland, metastatic malignancy to it (also code primary site) (← links)
- Site NOS, metastatic malignancy to it (also code primary site) (← links)
- Multiple endocrine adenomatosis (multiple endocrine neoplasia syndrome, MEN) (← links)
- Hyposplenism (← links)
- Alcohol (ethanol) acute intoxication (drunkenness) (← links)
- Opioid/narcotic, acute intoxication (← links)
- Sedative or hypnotic, acute intoxication (← links)
- Sedative or hypnotic, chronic abuse/dependence/addiction (← links)
- Cocaine, acute intoxication (← links)
- Cocaine, withdrawal (← links)
- Solvent (organic, inhaled or ingested), intoxication, acute (← links)
- Psychoactive substance NOS, acute intoxication (← links)
- Psychoactive substance NOS, withdrawal (← links)
- Cerebrospinal fluid (CSF) leak (← links)
- Antibiotic/antimicrobial, overdose/toxicity (← links)
- Hormone or hormone agonist NOS, overdose/toxicity (← links)
- Aspirin or other salicylate or NSAID, overdose/toxicity (← links)
- Acetaminophen (tylenol, paracematol), overdose/toxicity (← links)
- Cocaine, overdose/toxicity (← links)
- Opioid/narcotic, overdose/toxicity (← links)
- Hallucinogen, overdose/toxicity (← links)
- Benzodiazepine, overdose/toxicity (← links)
- Antiseizure drug NOS, overdose/toxicity (← links)
- Tricyclic antidepressant, overdose/toxicity (← links)
- Antidepressant drug NOS, overdose/toxicity (← links)
- Psychiatric drug NOS, overdose/toxicity (← links)
- Beta-blocker, overdose/toxicity (← links)
- Anticoagulant, overdose/toxicity (← links)
- Calcium channel blocker, overdose/toxicity (← links)
- Cardiac/cardiovascular drug NOS, overdose/toxicity (← links)
- Drug or biological substance/agent NOS, overdose/toxicity (← links)
- Toxic alcohols, poisoning (← links)
- Alkali, poisoning (← links)
- Acid or alkali (not specified which) or other corrosive substance, poisoning (← links)
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Show all ICD10 Subcategories
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ICD10 Categories:
ANCA-associated Vasculitis (AAV), Abdominal trauma, Abortion, Acute intoxication, Addiction, Adrenal Insufficiency, Adverse effect, Alcohol related, Allergy, Anemia, Anesthetic related, Aneurysm, Antibiotic resistance, Antidepressant related, Aortic Aneurysm, Arrhythmia, Arterial thromboembolism, Asthma, Atherosclerosis, Awaiting/delayed transfer, Bacteria, Benign neoplasm, Breast disease, Burn, COVID, Cannabis related, Cardiac septum problem, Cardiovascular, Cerebral Hemorrhage/Stroke, Chemical burn, Chronic kidney disease, Cirrhosis, Cocaine related, Decubitus ulcer, Delirium, Dementia, Diabetes, Diagnosis implying death, Double duty pathogen, ENT, Encephalitis, Encephalopathy, Endocrine disorder, Endocrine neoplasm, Exposure, Eye, Female genital neoplasm, Fistula, Fracture, Fungus, GI ulcer, Gastroenteritis, Gastrointestinal, Gastrointestinal neoplasm, Hallucinogen related, Has one, Head trauma, Head trauma (old), Healthcare contact, Heart valve disease, Heme/immunology, Heme/immunology neoplasm, Hemophilia, Hemorrhage, Hepatitis, Hereditary/congenital, Hernia, Hypertension, Hypotension, Iatrogenic, Iatrogenic infection, Iatrogenic mechanism, Imaging, Infection requiring pathogen, Infection with implied pathogen, Infectious disease, Inflammatory Bowel Disease, Influenza, Inhalation, Intra-abdominal infection, Ischemia, Ischemic gut, Ischemic heart disease, Joint/ligament trauma, Leukemia, Liver disease, Liver failure, Lower limb trauma, Lower respiratory tract infection, Lymphoma, Male genital neoplasm, Mechanism, Meningitis, Metabolic/nutrition, Metastasis, Misc, Muscle problem, Muscles/tendon trauma, Musculoskeletal/soft tissue, Musculoskeletal/soft tissue neoplasm... further results
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