Is T43.505 a billable ICD-10-CM code?

No. T43.505 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does T43.505 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 T43.505?

T43.505 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 T43.505 (T43.5) and apply to it just the same.

T43.505

T43.505 — Adverse effect of unspecified antipsychotics and neuroleptics

Non-billable headerICD-10-CM

T43.505 is a non-billable header ICD-10-CM code for adverse effect of 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 inherited from the categories above T43.505

These are not written on T43.505, but they bind it: a note on a category applies to every code beneath it. Billing T43.505 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 T43.505

Also inherited, and the opposite of Excludes1: these conditions are not part of T43.505, 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

T43.505 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 history

T43.505 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Code to one of these instead T43.505

3 child codes. Green means billable.

Related codes at this level

Codes that share T43.50. If T43.505 is not quite right, the correct code is usually one of these.

Questions about T43.505

Is T43.505 a billable ICD-10-CM code?: No. T43.505 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does T43.505 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 T43.505?: T43.505 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 T43.505 (T43.5) and apply to it just the same.