T43.215S
T43.215S — Adverse effect of selective serotonin and norepinephrine reuptake inhibitors, sequela
Billable / specific codeICD-10-CMPOA exempt
T43.215S is a billable, specific ICD-10-CM code for adverse effect of selective serotonin and norepinephrine reuptake inhibitors, sequela. It is valid for submission on a claim.
7th character "S" — sequela
The appropriate 7th character is to be added to each code from category T43
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment
T43.215S does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
T43.215S is named in 18 Medicare coverage policies — 18 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56531Billing and Coding: Octreotide Acetate for Injectable Suspension (Sandostatin® LAR Depot)
- A56612Billing and Coding: CT of the Head
- A56625Billing and Coding: Echocardiography
- A56625Billing and Coding: Echocardiography
Related codes at this level
Codes that share T43.215. If T43.215S is not quite right, the correct code is usually one of these.
Questions about T43.215S
- Is T43.215S a billable ICD-10-CM code?
- Yes. T43.215S is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T43.215S 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).