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2025 ICD-10-CM code T63.4

Toxic effect of venom from other arthropods.

Follow the official ICD-10-CM coding guidelines for injury, poisoning, and external causes.Use additional codes as needed to capture the full clinical picture.

Modifiers may be applicable depending on the circumstances of the encounter and the services provided.Consult the appropriate modifier guidelines.

Medical necessity for treatment is established by the presence of symptoms and/or complications resulting from the arthropod venom.The severity of the symptoms will determine the level of care required (e.g., observation, medication, hospitalization).

The clinical responsibility involves assessing the patient's condition, treating the immediate effects of the envenomation (e.g., pain management, wound care), monitoring for systemic complications, and providing appropriate supportive care as needed.This may involve administering antivenom in severe cases.

IMPORTANT:Additional codes may be required to specify the type of arthropod (e.g., T63.411 for centipedes and venomous millipedes) and any resulting complications (e.g., respiratory issues, allergic reactions).A secondary code from Chapter 20 (External causes of morbidity) should be used to indicate the cause of the injury (e.g., accidental, intentional self-harm).

In simple words: This code is used when someone is poisoned by the venom of an insect, centipede, or millipede (excluding spiders and scorpions). The symptoms can be a painful, red, itchy, or burning area where the insect bit or stung. In severe cases, there may be other more serious symptoms.

This code classifies the toxic effects resulting from venom exposure to arthropods other than scorpions and spiders.Arthropods included are insects, centipedes, and millipedes.The effects can range from localized reactions (pain, inflammation, redness, itching, burning) at the site of the bite or sting to more systemic reactions depending on the specific arthropod and the amount of venom injected.Additional codes may be necessary to specify the exact arthropod involved (e.g., centipede, millipede) and the nature and severity of the resulting symptoms (e.g., respiratory distress, allergic reaction).

Example 1: A patient presents to the emergency department with intense pain, swelling, and redness at the site of a centipede bite on their hand.They report an allergic reaction., A child is brought to the clinic after being stung multiple times by bees while playing outside.They are exhibiting localized reactions to the stings., A hiker is admitted to the hospital after being bitten by a venomous insect in a remote area. They are experiencing severe symptoms including difficulty breathing and a drop in blood pressure.

Detailed documentation should include the type of arthropod involved, the location and time of the bite or sting, description of the wound, the patient's symptoms (both local and systemic), treatment provided (e.g., wound care, antivenom administration), and the patient's response to treatment.

** Always refer to the most current version of the ICD-10-CM coding manual for the most up-to-date information and guidelines.

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