Differences Between Poisonings and Adverse Events
The diagnostic codes in the 292 section (i.e., Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision [DSM-IV-TR] codes 292.0, 292.11, 292.12, 292.81, 292.82, 292.83, 292.84, 292.89, and 292.9) are for drug-induced psychiatric symptoms regardless of the context in which the drug is used. The International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM) makes a distinction between "poisoning" (a broadly defined term for drugs that are "not used according to proper instructions" includes intentional overdose, accidental overdose, combining it with alcohol, etc.) and "adverse reaction" (drugs used as prescribed but that lead to symptoms as side effects).
For cases of "poisoning," ICD-9-CM requires first a poisoning code (from the 900 section of ICD-9-CM), and then the 292 code, and then the "appropriate E code from the Table of Drugs and Chemicals to indicate Accident, Suicide Attempt, or Assault." For cases of "adverse reaction", ICD-9-CM requires first the 292 code and then the "appropriate E code from the Table of Drugs and Chemicals to indicate Therapeutic Use." This was dealt with in part in DSM-IV-TR on pages 879-882 in Appendix G, which contains selected Poisoning codes and E codes for Therapeutic Use. (E codes for Accident, Suicide Attempt or Assault were not included, in order to minimize confusion). These codes have not been systematically reviewed to insure that they are up-to-date (i.e., they were probably lasted checked in 1994 and not since then given their infrequent use).