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ICD-10-CM T67.5XXA: Heat exhaustion, unspecified, initial encounter

T67.5XXA is the billable ICD-10-CM code for heat exhaustion, unspecified, initial encounter, in category T67 (Effects of heat and light) of the Other and unspecified effects of external causes section. As a principal diagnosis it groups to MS-DRG 922 Other Injury, Poisoning and Toxic Effect Diagnoses with MCC, MS-DRG 923 Other Injury, Poisoning and Toxic Effect Diagnoses without MCC (MDC 21 MDC 21: Injuries, Poisonings and Toxic Effects of Drugs). 1 LCD billing and coding article lists it as covered.

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: ICD-10-CM code descriptions: FY2027 (effective October 1, 2026); IPPS Table 5 (MS-DRG weights): v44 FY2027 (final rule + CN3) (effective October 1, 2026); ICD-10-CM to HCC mapping: PY2027 initial ICD-10-CM mappings (dates of service 2026) (payment year 2027); Medicare Coverage Database billing and coding articles: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: FY2028 code files, effective October 1, 2027 for the ICD-10-CM code descriptions; FY2028 final rule (August 2027), effective October 1, 2027; an April 1 interim grouper update when CMS issues one for the IPPS Table 5 (MS-DRG weights); PY2028 advance notice (February 2027) and the PY2027 midyear final mapping (spring 2027) for the ICD-10-CM to HCC mapping; weekly, every Thursday for the Medicare Coverage Database billing and coding articles.

Code
T67.5XXA
billable FY2027 ICD-10-CM code
Category
T67 Effects of heat and light
Chapter
19: Injury, poisoning and certain other consequences of external causes (S00-T88)
CC/MCC (MS-DRG v44)
Neither
CMS-HCC V28
Not mapped
POA reporting
Required

Tabular list notes for T67.5XXA

The tabular list has no notes on T67.5XXA itself; the notes below apply from its parent headings.

Inherited from T67 (Effects of heat and light)

Excludes1 (never coded together)
  • erythema [dermatitis] ab igne (L59.0)
  • malignant hyperpyrexia due to anesthesia (T88.3)
  • radiation-related disorders of the skin and subcutaneous tissue (L55-L59)
Excludes2 (not part of this condition, may be coded together)
  • burns (T20-T31)
  • sunburn (L55.-)
  • sweat disorder due to heat (L74-L75)

Inherited from T67.5 (Heat exhaustion, unspecified)

Inclusion terms
  • Heat prostration NOS

The 7th character A means “initial encounter”, as defined at T67. The same injury coded for a later encounter uses a different 7th character, so check each encounter.

MS-DRG grouping when T67.5XXA is the principal diagnosis

MS-DRG v44 groups for T67.5XXA as principal diagnosis
MDCMS-DRGs
21 MDC 21: Injuries, Poisonings and Toxic Effects of Drugs922923

The final group also depends on procedures, secondary diagnoses and discharge status; the MS-DRG lookup for T67.5XXA shows the full grouping logic.

CC/MCC status and inpatient edits

T67.5XXA is neither a CC nor an MCC under MS-DRG v44, so as a secondary diagnosis it does not raise the MS-DRG severity level. Check T67.5XXA against a principal diagnosis.

  • Present on admission: a POA indicator is required on inpatient claims.

CMS-HCC V28 risk adjustment

T67.5XXA does not map to a payment HCC in the PY2027 CMS-HCC V28 model, so on its own it does not change a Medicare Advantage risk score.

LCD billing and coding articles that list T67.5XXA

1 current Medicare billing and coding article lists T67.5XXA among the diagnoses that support medical necessity for the services they cover.

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Frequently asked questions

What does ICD-10-CM T67.5XXA mean?

T67.5XXA means heat exhaustion, unspecified, initial encounter. It is one of 25 billable codes under T67, effects of heat and light.

Which MS-DRG does T67.5XXA group to?

As the principal diagnosis, T67.5XXA groups to MS-DRG 922 Other Injury, Poisoning and Toxic Effect Diagnoses with MCC, MS-DRG 923 Other Injury, Poisoning and Toxic Effect Diagnoses without MCC (MDC 21 MDC 21: Injuries, Poisonings and Toxic Effects of Drugs) under MS-DRG v44, before procedures and secondary diagnoses are applied.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

The descriptor and notes are reproduced from the FY2027 ICD-10-CM files; MS-DRG, CC/MCC and HCC facts come from the CMS FY2027 and PY2027 tables. Code from the medical record and the ICD-10-CM Official Guidelines. Not legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.