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T43.295S

T43.295SAdverse effect of other antidepressants, sequela

Billable / specific codeICD-10-CMPOA exempt

T43.295S is a billable, specific ICD-10-CM code for adverse effect of other antidepressants, 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

Excludes2 inherited from the categories above T43.295S

Also inherited, and the opposite of Excludes1: these conditions are not part of T43.295S, but a patient can have both, so you may code both.

Written on T43 Poisoning by, adverse effect of and underdosing of psychotropic drugs, not elsewhere classified

  • appetite depressants (T50.5-)
  • barbiturates (T42.3-)
  • benzodiazepines (T42.4-)
  • drug dependence and related mental and behavioral disorders due to psychoactive substance use (F10.- -F19.-)
  • methaqualone (T42.6-)
  • psychodysleptics [hallucinogens] (T40.7-T40.9-)

Risk adjustment

T43.295S 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

T43.295S is named in 22 Medicare coverage policies 22 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

  • A56612Billing and Coding: CT of the Head
  • A56625Billing and Coding: Echocardiography
  • A56625Billing and Coding: Echocardiography
  • A56844Billing and Coding: RAST Type Tests

Code history

T43.295S has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share T43.295. If T43.295S is not quite right, the correct code is usually one of these.

Questions about T43.295S

Is T43.295S a billable ICD-10-CM code?
Yes. T43.295S is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does T43.295S 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).
ICD-10-CMFY2026-Apr· effective April 1, 2026

Loaded directly from the CMS/NCHS ICD-10-CM public-domain release — see data sources and our editorial policy. If this page disagrees with the CMS tabular list, this page is wrong. Reference information for professional coders; not medical or billing advice.