T43.212A — Poisoning by selective serotonin and norepinephrine reuptake inhibitors, intentional self-harm, initial encounter
T43.212A is a billable, specific ICD-10-CM code for poisoning by selective serotonin and norepinephrine reuptake inhibitors, intentional self-harm, initial encounter. It is valid for submission on a claim.
7th character "A" — initial encounter
The appropriate 7th character is to be added to each code from category T43
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment
T43.212A risk-adjusts. Under the CMS-HCC V28 model it maps to these categories:
- HCC 155 Major Depression, Moderate or Severe, without Psychosis0.299 RAF
- HCC 155 Major Depression, Moderate or Severe, without Psychosis0.299 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
T43.212A is named in 12 Medicare coverage policies — 12 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A54799Billing and Coding: Urine Drug Testing
- A55001Billing and Coding: Urine Drug Testing
- A56612Billing and Coding: CT of the Head
- A56645Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Related codes at this level
Codes that share T43.212. If T43.212A is not quite right, the correct code is usually one of these.
Questions about T43.212A
- Is T43.212A a billable ICD-10-CM code?
- Yes. T43.212A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T43.212A sit in the tabular list?
- Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Poisoning by, adverse effects of and underdosing of drugs, medicaments and biological substances (T36-T50).