T43.96XA
T43.96XA: Underdosing of unspecified psychotropic drug, initial encounter
Billable / specific codeICD-10-CM
T43.96XA is a billable, specific ICD-10-CM code for underdosing of unspecified psychotropic drug, initial encounter. It is valid for submission on a claim.
Check T43.96XA with the rest of the claim: free scrubber7th character "A": initial encounter
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 T43.96XA
Not part of this code, but both may be coded when both are present.
Written on T43: Poisoning by, adverse effect of and underdosing of psychotropic drugs, not elsewhere classified
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
T43.96XA is named in 2 Medicare coverage policies: 2 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A56612Billing and Coding: CT of the Head
- A56645Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Code history
Unchanged in every release from FY2024 to FY2027.