T40.902S ICD-10-CM Code: Poisoning by unspecified psychodysleptics [hallucinogens], intentional self-harm, sequela
T40.902S is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools
HCC Buddy Code Card
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FY 2026 Apr update / Injury, poisoning and certain other consequences of external causes (S00-T88) / Poisoning by, adverse effects of and underdosing of drugs, medicaments and biological substances (T36-T50)
T40.902S
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidancePoisoning by unspecified psychodysleptics [hallucinogens], intentional self-harm, sequela
Poisoning by unspecified psychodysleptics [hallucinogens], intentional self-harm, sequela
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
MappedHCC 59
Code-level coefficient reference
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for T40.902S in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for T40.902S in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for T40.902S in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for T40.902S in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for T40.902S in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for T40.902S in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for T40.902S in this effective period.
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is T40.902S an HCC code?
T40.902S is not in the CMS-HCC V28 or V24 community payment model. T40.902S has a separate mapping under the CMS-HCC ESRD model (HCC 59 (Major Depressive/Bipolar/and Paranoid Disorders)); the applicable result needs member context.
- Code
- T40.902S
- Description
- Poisoning by unspecified psychodysleptics [hallucinogens], intentional self-harm, sequela
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.
Work T40.902S in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT Criteria for T40.902S
For T40.902S to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed T40.902S during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
T40.902S is the ICD-10-CM diagnosis code for poisoning by unspecified psychodysleptics [hallucinogens], intentional self-harm, sequela. T40.902S sits in the ICD-10-CM chapter for injury, poisoning and certain other consequences of external causes (s00-t88), within the section covering poisoning by, adverse effects of and underdosing of drugs, medicaments and biological substances (t36-t50).
T40.902S has no mapping under the CMS-HCC V28 or V24 community payment models. T40.902S has a separate mapping under the CMS-HCC ESRD model (HCC 59 (Major Depressive/Bipolar/and Paranoid Disorders)); the applicable result needs member context. Do not assign V28 risk adjustment value from this page; verify the applicable model and payment year before using this code for risk adjustment.
T40.902S is a billable ICD-10-CM code, but the current payload does not show a mapping under the CMS-HCC V28 or V24 community payment models. It does map under the CMS-HCC ESRD model, and that result depends on member context rather than on the V28 community model. Do not assign risk adjustment value from this page when no source-backed mapping is shown. Coders should check the current model files and select only the specificity supported by the provider documentation.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for T40.902S sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.