T58.02XA: Toxic effect of carbon monoxide from motor vehicle exhaust, intentional self-harm, initial encounter

T58.02XA, toxic effect of carbon monoxide from motor vehicle exhaust, intentional self-harm, initial encounter, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 28 HCPCS Level II codes, including J0461 (Injection, atropine sulfate, 0.01 mg), J0153 (Injection, adenosine, 1 mg (not to be used to report any…), J1250 (Injection, dobutamine hydrochloride, per 250 mg). The articles come from 2 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.

HCPCS Level II codes with T58.02XA as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
J0461Injection, atropine sulfate, 0.01 mgSpecial coverage instructions apply—2
J0153Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds)Special coverage instructions apply—2
J1250Injection, dobutamine hydrochloride, per 250 mgSpecial coverage instructions apply—2
J0280Injection, aminophyllin, up to 250 mgSpecial coverage instructions apply—2
J1245Injection, dipyridamole, per 10 mgSpecial coverage instructions apply—2
A9700Supply of injectable contrast material for use in echocardiography, per studySpecial coverage instructions apply—2
J2785Injection, regadenoson, 0.1 mgCarrier judgment—1
J3490Unclassified drugsSpecial coverage instructions apply—1
Q9957Injection, perflutren lipid microspheres, per mlCarrier judgment—1
Q9956Injection, octafluoropropane microspheres, per mlCarrier judgment—1
C9399Unclassified drugs or biologicalsSpecial coverage instructions apply—1
C8921Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; completeSpecial coverage instructions apply—1
C8922Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; follow-up or limited studySpecial coverage instructions apply—1
C8923Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, without spectral or color doppler echocardiographySpecial coverage instructions apply—1
C8924Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, follow-up or limited studySpecial coverage instructions apply—1
C8928Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and reportSpecial coverage instructions apply—1
C8929Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiographySpecial coverage instructions apply—1
C8930Transthoracic echocardiography, with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuous electrocardiographic monitoring, with physician supervisionSpecial coverage instructions apply—1
Q9955Injection, perflexane lipid microspheres, per mlCarrier judgment—1
G2187Patients with clinical indications for imaging of the head: head traumaCarrier judgment—1
G2188Patients with clinical indications for imaging of the head: new or change in headache above 50 years of ageCarrier judgment—1
G2189Patients with clinical indications for imaging of the head: abnormal neurologic examCarrier judgment—1
G2190Patients with clinical indications for imaging of the head: headache radiating to the neckCarrier judgment—1
G2191Patients with clinical indications for imaging of the head: positional headachesCarrier judgment—1
G2192Patients with clinical indications for imaging of the head: temporal headaches in patients over 55 years of ageCarrier judgment—1

3 more codes are listed. See every code with payment by region in Caduvo.

Medicare policy articles listing T58.02XA

A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.

Other T58 diagnoses (Toxic effect of carbon monoxide)

Frequently asked questions

Does Medicare cover T58.02XA (Toxic effect of carbon monoxide from motor vehicle…)?

Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list T58.02XA as a covered diagnosis for 28 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.

Which HCPCS codes can be billed with ICD-10 T58.02XA?

The Level II codes from the policies most specific to this diagnosis are J0461 (Injection, atropine sulfate, 0.01 mg, 2 articles); J0153 (Injection, adenosine, 1 mg (not to be used to report any…, 2 articles); J1250 (Injection, dobutamine hydrochloride, per 250 mg, 2 articles); J0280 (Injection, aminophyllin, up to 250 mg, 2 articles); J1245 (Injection, dipyridamole, per 10 mg, 2 articles). Code choice depends on the item supplied; check each code's descriptor.

Which Medicare policy articles list T58.02XA?

A57306 (Billing and Coding: Transthoracic Echocardiography (TTE)); A56625 (Billing and Coding: Echocardiography); A56612 (Billing and Coding: CT of the Head).

What is ICD-10-CM code T58.02XA?

T58.02XA is the ICD-10-CM code for toxic effect of carbon monoxide from motor vehicle exhaust, intentional self-harm, initial encounter, in category T58 (Toxic effect of carbon monoxide), chapter 19: Injury, poisoning and other consequences of external causes.

Next steps

Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.

Chapter 19: Injury, poisoning and other consequences of external causes · All diagnoses · HCPCS lookup