POISONING CODES:-Poison: – Poison is anything that kills or injures through its chemical actions. Most poisons are swallowed (ingested). Poisons can also enter the body in other ways by breathing, through the skin, by IV injections, from exposure to radiation, venom from a snake bite, etc Poisoning codes contains classification of drugs and other chemical substances to identify poisoning states and external causes of adverse effects. Poisoning: – When the substance not used exactly as prescribed. Adverse effect: – When the substance used as prescribed. Common Terms For The Poisoning:- 1. Wrong medication given or taken. 2. Wrong dosage [overdose] given or taken. 3. Medication given to or taken by wrong person. Each of the substances is assigned by the codes according to the poisoning classification [960-989]. These codes are used when there is a statement of poisoning, overdose, wrong substance given or taken or intoxication. It also contains a list of external causes of adverse effects. It’s assigned by E-Codes. E-Codes are alpha numerical codes identified by ICD-9-CM for the external causes of injury and poisoning. E-Codes injury or poisoning caused intent {unintentional or accidental or intentional such as assault or suicide} and the place where the event occurred. Categories of E-Codes:- 1. Transport accident. 2. Poisoning and adverse effects {severe side effects} of drugs, medicinal substances and biological substances, 3. Accidental falls. 4. Accidentals caused by fire and flames. 5. Accidents due to natural and environmental factors. 6. Late effects of accidents, assaults or self injury. 7. Suicide or self inflicted injury. Note:- There is no late effect E-Code for adverse effect of drugs.
Adverse effect used from therapeutic use.
Use an additional code from E849 to indicate the place of occurrence for injuries and poisoning, and don’t code E849.9 if the place of occurrence not stated.
Rules For Poisoning Codes:-
1st list the poisoning code. 2nd code the condition. 3rd E-Code, how the poison occurred.
Rules For Adverse Effect Codes:-
1st code the condition. 2nd E-Code {adverse effect/ therapeutic use}, how the poison occurred.
E-Codes are listed in 5 Categories:
1. Accident:- Accidental overdose of drugs, wrong substances given or taken.
2. Therapeutic use/Adverse Effect:- A correct substance properly administered in therapeutic dosage as the external cause of adverse effect.{When the substance used as prescribed}
3. Suicide attempt: – Instances in which self-inflicted injuries or poisoning are involved.
4. Assault: – Injury or poisoning inflicted by another person with the intent to injure or kill.
5. Undetermined: – When the intent of the poisoning or injury can’t be determined whether it was intentional or accidental.
EXAMPLES:-
1. Supraventricular premature heartbeats secondary to use of digitalis{Drugs}
Codes:- Px: Supraventricular premature heart beats [condition]- 427.61
Sx: digitalis – E942.1 [Therapeutic use]
Px: Primary Sx: Secondary
2. Dry mouth due to taking Phenobarbital
Codes: – Px: Dry mouth- 527.7
Sx: Phenobarbital- E937.0 [Therapeutic use-adverse effect]
3. Parkinsonism due to use of haloperidol [drugs]
Codes: – Px: Parkinsonism – 332.1
Sx: Haloperidol- E939.2 [Therapeutic use]
4. Supraventricular tachycardia due to digoxin.
Codes: – Px: Supraventricular tachycardia- 427.0
Sx: digoxin – E942.1 [Therapeutic use]
5. convulsion due to darvon
Codes:- Px: Convulsion – 780.39
Sx: Darvon- E-935.8 [Therapeutic use]
ACCIDENT CASE:-
1. Convulsions due to accidental overdose of darvon
Codes:- 1st code the poisoning darvon- 965.8
Then code the condition Convulsions – 780.39
Then E-Code accidental overdose of darvon- E850.8
SUICIDE ATTEMPT:-
1. Cerebral anoxia due to barbiturate overdose suicide attempt.
Codes:- 1st code the poisoning barbiturate- 967.0
Then code the condition cerebral anoxia- 348.1
Then E-Code suicide attempt- E950.1
2. Coma due to overdose of Phenobarbital.
Codes:- 1st code the poisoning Phenobarbital- 967.0
Then code the condition coma- 780.01
Then E-Code [unidentified] – E980.1
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