T43.605A — Adverse effect of unspecified psychostimulants, initial encounter
Is T43.605A billable?
Yes, but T43.605A is an unspecified code. T43.605A is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, T43.605A is an unspecified or catch-all code. Payers apply additional scrutiny to unspecified codes and many deny them when the medical record supports a more specific option, so check the documentation before selecting T43.605A — the more specific alternatives are listed below.
More specific alternatives
- T43.611APoisoning by caffeine, accidental (unintentional), initial encounter
- T43.621APoisoning by amphetamines, accidental (unintentional), initial encounter
- T43.631APoisoning by methylphenidate, accidental (unintentional), initial encounter
- T43.641APoisoning by ecstasy, accidental (unintentional), initial encounter
- T43.651APoisoning by methamphetamines accidental (unintentional), initial encounter
- T43.691APoisoning by other psychostimulants, accidental (unintentional), initial encounter
T43.605A at a glance
| Code | T43.605A |
|---|---|
| Description | Adverse effect of unspecified psychostimulants, initial encounter |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "A" | initial encounter |
What does the 7th character "A" mean in T43.605A?
In T43.605A, the 7th character A means initial encounter. The 7th character is required for T43.605A to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
What Medicare edits apply to T43.605A?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name T43.605A directly.
CMS will reject this code as the principal diagnosis on an inpatient claim. It describes something other than the condition chiefly responsible for the admission.
Which MS-DRGs does T43.605A group to?
T43.605A sits in MDC 15 and helps define the logic of 1 MS-DRG (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 791Prematurity with Major Problemsmedical
Excludes1 — never code together — inherited from T36-T50
The conditions below can never be reported together with T43.605A on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- toxic reaction to local anesthesia in pregnancy (O29.3-)
Excludes1 — never code together — inherited from T43.6
The conditions below can never be reported together with T43.605A on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- poisoning by, adverse effect of and underdosing of cocaine (T40.5-)
Code first — inherited from T36-T50
The underlying condition below must be sequenced before T43.605A. T43.605A describes a manifestation and cannot be the principal or first-listed diagnosis.
Use additional code — inherited from Chapter 19
Report an additional code alongside T43.605A to fully describe the condition. T43.605A is sequenced first.
- code to identify any retained foreign body, if applicable (Z18.-)
Use additional code — inherited from T36-T50
Report an additional code alongside T43.605A to fully describe the condition. T43.605A is sequenced first.
Excludes2 — not included here — inherited from Chapter 19
The conditions below are not part of T43.605A, but a patient may have both at the same time. When documentation supports it, T43.605A and the excluded code may both be reported.
Excludes2 — not included here — inherited from T36-T50
The conditions below are not part of T43.605A, but a patient may have both at the same time. When documentation supports it, T43.605A and the excluded code may both be reported.
Excludes2 — not included here — inherited from T43
The conditions below are not part of T43.605A, but a patient may have both at the same time. When documentation supports it, T43.605A and the excluded code may both be reported.
How long has T43.605A existed?
T43.605A has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.