Hallucinogen, overdose/toxicity
| ICD10 Diagnosis | |
| Dx: | Hallucinogen, overdose/toxicity |
| ICD10 code: | T40.9 |
| Pre-ICD10 counterpart: | none assigned |
| Charlson/ALERT Scale: | none |
| APACHE Como Component: | none |
| APACHE Acute Component: | 2019-0: Drug OD |
| Start Date: | |
| Stop Date: | |
| External ICD10 Documentation | |
This diagnosis is a part of ICD10 collection.
Additional Info
Common hallucinogens
- LSD (lysergic acid diethylamide)
- PCP (phencyclidine)
- magic mushrooms (psilocybin)
- ketamine
- mescaline (peyote cactus)
- morning glory seeds
- datura
- don't include cannabis under general hallucinogens, see
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).
See ICD10 Guideline for drugs and substances for more info on coding substance related ICD10 diagnoses.
Distinguishing between Sedative/hypnotics, Hallucinogens, and Psychoactive substances
Common sedatives or hypnotics
- benzodiazepines
- barbiturates
- dilantin and most other antiseizure drugs
- tricyclics and most anti-depressants (but not lithium, which is categorized under “Psychiatric drug NOS”)
- xylazine is a non-opiate sedative, analgesic and muscle relaxant authorized for veterinary use in the US, now being found in a number of illicit drug mixtures such as fentanyl, cocaine and heroin
Common hallucinogens
- LSD (lysergic acid diethylamide)
- PCP (phencyclidine)
- magic mushrooms (psilocybin)
- ketamine
- mescaline (peyote cactus)
- morning glory seeds
- datura
- don't include cannabis under general hallucinogens, see
Common Psychoactive Substances
- Pharmaceuticals:
- lithium
- phenothiazines
- olanzapine (Zyprexa)
- respiradone (Respirdol
- quetiapine (Seroquel)
- methylphenidate(Ritalin)
- amphetamines (Adderol)
- other antipsychotics
- Street drugs/agents:
- ecstacy (MDMA), also referred to as Molly
- nitrous oxide
Alternate ICD10s to consider coding instead or in addition
| Hallucinogen related codes: |
Candidate Combined ICD10 codes
Related CCI Codes
Data Integrity Checks (automatic list)
none found
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