T40.415SAdverse effect of fentanyl or fentanyl analogs, sequela

T40.415S is the ICD-10-CM diagnosis code for adverse effect of fentanyl or fentanyl analogs, sequela. It belongs to category T40 (poisoning by, adverse effect of and underdosing of narcotics and psychodysleptics [hallucinogens]), block T36-T50 (poisoning by, adverse effects of and underdosing of drugs, medicaments and biological substances) and chapter 19 (injury, poisoning and certain other consequences of external causes). It is billable, so it can be reported on its own for dates of service from October 1, 2026 through September 30, 2027.

The 7th character "S" means sequela: use it for complications or conditions that arise as a direct result of the original condition.

It is not a CC or MCC, so as a secondary diagnosis it doesn't change the MS-DRG severity level.

In MS-DRG v44.0, it is part of the grouping logic for DRG 922 (Other Injury, Poisoning and Toxic Effect Diagnoses with MCC, relative weight 1.6238) and DRG 923 (Other Injury, Poisoning and Toxic Effect Diagnoses without MCC, relative weight 0.9973), in MDC 21 (Injuries, Poisonings and Toxic Effects of Drugs), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.

It is not acceptable as the principal diagnosis for an inpatient stay; it may be reported as a secondary diagnosis.

It is exempt from present-on-admission (POA) reporting, so no POA indicator is required.

It was added in FY2021, effective October 1, 2020.