T43.5 — Poisoning by, adverse effect of and underdosing of other and unspecified antipsychotics and neuroleptics
T43.5 is a non-billable header ICD-10-CM code for poisoning by, adverse effect of and underdosing of other and unspecified antipsychotics and neuroleptics. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.
This code requires a 7th character
The appropriate 7th character is to be added to each code from category T43
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- poisoning by, adverse effect of and underdosing of rauwolfia (T46.5-)
Risk adjustment
T43.5 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.
Code to one of these instead T43.5
2 child codes. Green means billable.
Related codes at this level
Codes that share T43. If T43.5 is not quite right, the correct code is usually one of these.
- T43.0Poisoning by, adverse effect of and underdosing of tricyclic and tetracyclic antidepressants
- T43.1Poisoning by, adverse effect of and underdosing of monoamine-oxidase-inhibitor antidepressants
- T43.2Poisoning by, adverse effect of and underdosing of other and unspecified antidepressants
- T43.3Poisoning by, adverse effect of and underdosing of phenothiazine antipsychotics and neuroleptics
- T43.4Poisoning by, adverse effect of and underdosing of butyrophenone and thiothixene neuroleptics
- T43.6Poisoning by, adverse effect of and underdosing of psychostimulants
- T43.8Poisoning by, adverse effect of and underdosing of other psychotropic drugs
- T43.9Poisoning by, adverse effect of and underdosing of unspecified psychotropic drug
Questions about T43.5
- Is T43.5 a billable ICD-10-CM code?
- No. T43.5 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does T43.5 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).
- What cannot be coded together with T43.5?
- T43.5 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.