Is T43.501S a billable ICD-10-CM code?

Yes. T43.501S is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does T43.501S 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 T43.501S?

T43.501S carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above T43.501S (T43.5) and apply to it just the same.

T43.501S

T43.501S — Poisoning by unspecified antipsychotics and neuroleptics, accidental (unintentional), sequela

Billable / specific codeICD-10-CMPOA exempt

T43.501S is a billable, specific ICD-10-CM code for poisoning by unspecified antipsychotics and neuroleptics, accidental (unintentional), 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

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Poisoning by antipsychotics and neuroleptics NOS

Excludes1 inherited from the categories above T43.501S

These are not written on T43.501S, but they bind it: a note on a category applies to every code beneath it. Billing T43.501S with anything listed here is a denial.

Written on T43.5 — Poisoning by, adverse effect of and underdosing of other and unspecified antipsychotics and neuroleptics

poisoning by, adverse effect of and underdosing of rauwolfia (T46.5-)

Excludes2 inherited from the categories above T43.501S

Also inherited, and the opposite of Excludes1: these conditions are not part of T43.501S, 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

T43.501S 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

T43.501S is named in 3 Medicare coverage policies — 3 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
A57473Billing and Coding: Allergy Testing
A57473Billing and Coding: Allergy Testing

Code history

T43.501S 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 T43.501. If T43.501S is not quite right, the correct code is usually one of these.

Questions about T43.501S

Is T43.501S a billable ICD-10-CM code?: Yes. T43.501S is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does T43.501S 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 T43.501S?: T43.501S carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above T43.501S (T43.5) and apply to it just the same.