2024 ICD-10-CM Diagnosis Code T43.014A

Poisoning by tricyclic antidepressants, undetermined, initial encounter

ICD-10-CM Code:
T43.014A
ICD-10 Code for:
Poisoning by tricyclic antidepressants, undetermined, init
Is Billable?
Yes - Valid for Submission
Chronic Condition Indicator: [1]
Not chronic
Code Navigator:

Code Classification

  • Injury, poisoning and certain other consequences of external causes
    (S00–T88)
    • Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances
      (T36-T50)
      • Poisoning by, adverse effect of and underdosing of psychotropic drugs, not elsewhere classified
        (T43)

T43.014A is a billable diagnosis code used to specify a medical diagnosis of poisoning by tricyclic antidepressants, undetermined, initial encounter. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.

T43.014A is an initial encounter code, includes a 7th character and should be used while the patient is receiving active treatment for a condition like poisoning by tricyclic antidepressants undetermined. According to ICD-10-CM Guidelines an "initial encounter" doesn't necessarily means "initial visit". The 7th character should be used when the patient is undergoing active treatment regardless if new or different providers saw the patient over the course of a treatment. The appropriate 7th character codes should also be used even if the patient delayed seeking treatment for a condition.

Clinical Classification

Clinical CategoryCCSR Category CodeInpatient Default CCSROutpatient Default CCSR
External cause codes: intent of injury, undeterminedEXT023N - Not default inpatient assignment for principal diagnosis or first-listed diagnosis.N - Not default outpatient assignment for principal diagnosis or first-listed diagnosis.
External cause codes: poisoning by drugEXT014N - Not default inpatient assignment for principal diagnosis or first-listed diagnosis.N - Not default outpatient assignment for principal diagnosis or first-listed diagnosis.
Poisoning by drugs, initial encounterINJ022Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.

Clinical Information

  • Amitriptyline

    tricyclic antidepressant with anticholinergic and sedative properties. it appears to prevent the re-uptake of norepinephrine and serotonin at nerve terminals, thus potentiating the action of these neurotransmitters. amitriptyline also appears to antagonize cholinergic and alpha-1 adrenergic responses to bioactive amines.
  • Amoxapine

    the n-demethylated derivative of the antipsychotic agent loxapine that works by blocking the reuptake of norepinephrine, serotonin, or both; it also blocks dopamine receptors. amoxapine is used for the treatment of depression.
  • Clomipramine

    a tricyclic antidepressant similar to imipramine that selectively inhibits the uptake of serotonin in the brain. it is readily absorbed from the gastrointestinal tract and demethylated in the liver to form its primary active metabolite, desmethylclomipramine.
  • Desipramine

    a tricyclic dibenzazepine compound that potentiates neurotransmission. desipramine selectively blocks reuptake of norepinephrine from the neural synapse, and also appears to impair serotonin transport. this compound also possesses minor anticholinergic activity, through its affinity to muscarinic receptors.
  • Dothiepin

    a tricyclic antidepressant with some tranquilizing action.
  • Doxepin

    a dibenzoxepin tricyclic compound. it displays a range of pharmacological actions including maintaining adrenergic innervation. its mechanism of action is not fully understood, but it appears to block reuptake of monoaminergic neurotransmitters into presynaptic terminals. it also possesses anticholinergic activity and modulates antagonism of histamine h(1)- and h(2)-receptors.
  • Cytochrome P-450 CYP2D6

    a cytochrome p450 enzyme that catalyzes the hydroxylation of many drugs and environmental chemicals, such as debrisoquine; adrenergic receptor antagonists; and tricyclic antidepressants. this enzyme is deficient in up to 10 percent of the caucasian population.
  • Imipramine

    the prototypical tricyclic antidepressant. it has been used in major depression, dysthymia, bipolar depression, attention-deficit disorders, agoraphobia, and panic disorders. it has less sedative effect than some other members of this therapeutic group.
  • Iprindole

    a tricyclic antidepressant that has actions and uses similar to those of amitriptyline, but has only weak antimuscarinic and sedative effects. (from martindale, the extra pharmacopoeia, 30th ed, p257)
  • Lofepramine

    a psychotropic imipramine derivative that acts as a tricyclic antidepressant and possesses few anticholinergic properties. it is metabolized to desipramine.
  • Nortriptyline

    a metabolite of amitriptyline that is also used as an antidepressive agent. nortriptyline is used in major depression, dysthymia, and atypical depressions.
  • Opipramol

    a tricyclic antidepressant with actions similar to amitriptyline.
  • Protriptyline

    tricyclic antidepressant similar in action and side effects to imipramine. it may produce excitation.
  • Trimipramine

    tricyclic antidepressant similar to imipramine, but with more antihistaminic and sedative properties.

Coding Guidelines

When coding a poisoning or reaction to the improper use of a medication (e.g., overdose, wrong substance given or taken in error, wrong route of administration), first assign the appropriate code from categories T36-T50. The poisoning codes have an associated intent as their 5th or 6th character (accidental, intentional self-harm, assault and undetermined. If the intent of the poisoning is unknown or unspecified, code the intent as accidental intent. The undetermined intent is only for use if the documentation in the record specifies that the intent cannot be determined. Use additional code(s) for all manifestations of poisonings.

The appropriate 7th character is to be added to each code from block Poisoning by, adverse effect of and underdosing of psychotropic drugs, not elsewhere classified (T43). Use the following options for the aplicable episode of care:

  • A - initial encounter
  • D - subsequent encounter
  • S - sequela

Convert T43.014A to ICD-9-CM

  • ICD-9-CM Code: 969.05 - Pois tricyclc antidepres
    Combination Flag - Multiple codes are needed to describe the source diagnosis code. Correct coding should be done based on contextual judgment.
  • ICD-9-CM Code: E980.3 - Undeterm pois-psychotrop
    Combination Flag - Multiple codes are needed to describe the source diagnosis code. Correct coding should be done based on contextual judgment.

Table of Drugs and Chemicals

The parent code T43.014 of the current diagnosis code is referenced in the Table of Drugs and Chemicals, this table contains a classification of drugs, industrial solvents, corrosive gases, noxious plants, pesticides, and other toxic agents.

According to ICD-10-CM coding guidelines it is advised to do not code directly from the Table of Drugs and Chemicals, instead always refer back to the Tabular List when doing the initial coding. Each substance in the table is assigned a code according to the poisoning classification and external causes of adverse effects. It is important to use as many codes as necessary to specify all reported drugs, medicinal or chemical substances. If the same diagnosis code describes the causative agent for more than one adverse reaction, poisoning, toxic effect or underdosing, utilize the code only once.

Substance Poisoning
Accidental
(unintentional)
Poisoning
Accidental
(self-harm)
Poisoning
Assault
Poisoning
Undetermined
Adverse
effect
Underdosing
AllegronT43.011T43.012T43.013T43.014T43.015T43.016
AmineptineT43.011T43.012T43.013T43.014T43.015T43.016
AmitriptylineT43.011T43.012T43.013T43.014T43.015T43.016
AmitriptylinoxideT43.011T43.012T43.013T43.014T43.015T43.016
AmoxapineT43.011T43.012T43.013T43.014T43.015T43.016
ButriptylineT43.011T43.012T43.013T43.014T43.015T43.016
ChlorimipramineT43.011T43.012T43.013T43.014T43.015T43.016
CianopramineT43.011T43.012T43.013T43.014T43.015T43.016
ClomipramineT43.011T43.012T43.013T43.014T43.015T43.016
DesipramineT43.011T43.012T43.013T43.014T43.015T43.016
DesmethylimipramineT43.011T43.012T43.013T43.014T43.015T43.016
DibenzepinT43.011T43.012T43.013T43.014T43.015T43.016
DosulepinT43.011T43.012T43.013T43.014T43.015T43.016
DothiepinT43.011T43.012T43.013T43.014T43.015T43.016
DoxepinT43.011T43.012T43.013T43.014T43.015T43.016
ImipramineT43.011T43.012T43.013T43.014T43.015T43.016
IprindoleT43.011T43.012T43.013T43.014T43.015T43.016
LaroxylT43.011T43.012T43.013T43.014T43.015T43.016
LofepramineT43.011T43.012T43.013T43.014T43.015T43.016
MelitracenT43.011T43.012T43.013T43.014T43.015T43.016
MetapramineT43.011T43.012T43.013T43.014T43.015T43.016
NortriptylineT43.011T43.012T43.013T43.014T43.015T43.016
NoxiptilineT43.011T43.012T43.013T43.014T43.015T43.016
OpipramolT43.011T43.012T43.013T43.014T43.015T43.016
PertofraneT43.011T43.012T43.013T43.014T43.015T43.016
ProtriptylineT43.011T43.012T43.013T43.014T43.015T43.016
QuinupramineT43.011T43.012T43.013T43.014T43.015T43.016
SarotenT43.011T43.012T43.013T43.014T43.015T43.016
SinequanT43.011T43.012T43.013T43.014T43.015T43.016
TofranilT43.011T43.012T43.013T43.014T43.015T43.016
TrimipramineT43.011T43.012T43.013T43.014T43.015T43.016
TryptizolT43.011T43.012T43.013T43.014T43.015T43.016

Patient Education


Antidepressants

What are antidepressants?

Antidepressants are prescription medicines to treat depression. Depression is more than feeling a little sad or "blue" for a few days. It's a very common, serious medical illness that affects your mood and general mental health It can make you feel tired, hopeless, worried, or fearful. It can change your thinking, sleeping, and eating. Depression may make some people think about ending their lives.

But antidepressants can help many people who have depression. Researchers think antidepressants may help improve the way your brain uses certain chemicals that control mood or stress.

Are antidepressants used for other conditions?

A health care provider may prescribe antidepressants for anxiety, chronic pain, or insomnia. Sometimes providers also prescribe antidepressants for other conditions.

What are the different types of antidepressants?

There are many types of antidepressants. Each one works differently. Providers usually prescribe newer antidepressants first because they don't cause as many side effects as older types. They also seem to help more kinds of depression and anxiety problems.

Most of the newer antidepressants belong to one of these three groups:

  • Selective serotonin reuptake inhibitors (SSRIs)
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs)
  • Atypical antidepressants, which are newer antidepressants that don't fit into the other groups

If these antidepressants don't help, your provider might suggest one of the older antidepressants. The older types include tricyclic antidepressants (TCAs), tetracyclics, and monoamine oxidase inhibitors (MAOIs). Even though these antidepressants may cause more serious side effects, the benefits may outweigh the risks for some people.

Which type of antidepressant is right for me?

Our bodies and brains all work differently. That means one antidepressant won't work for everyone. You may need to try two or more medicines before you find one that works for you.

Your provider will work with you to choose the best option to try first. You'll consider questions such as:

  • Which symptoms bother you most? Some antidepressants may do a better job helping specific symptoms, such as trouble sleeping.
  • What other medicines and supplements do you take? Some antidepressants can cause problems if you take them with certain medicines and herbs.
  • Did a certain antidepressant work well for a close relative? An antidepressant that helped a parent, brother, or sister could be a good choice for you, too.
  • Do you have other health conditions? Certain antidepressants can make some other conditions better or worse. Any other conditions that you have will be part of choosing your depression treatment.
  • Are you pregnant, planning for pregnancy, or breastfeeding? If so, your provider will help you find a way to treat your depression that's safe for you and your baby.

How long do antidepressants take to work?

Antidepressants usually take 4 to 8 weeks to work, so you'll need to be patient. You may notice that some problems, such as sleeping and eating, get better before your mood improves. That's a good sign. You may just need to give the medicine a little more time to do its job.

Sometimes an antidepressant helps at first, but symptoms return while you're still taking it. But there's usually another one you can try. To get more relief from depression, your provider may suggest combining two antidepressants, using another kind of medicine with an antidepressant, or adding talk therapy or other approaches to improve your mental health.

How long will I need to take an antidepressant?

When an antidepressant starts to work, you and your provider can decide how long you need to stay on it. The typical length of treatment is 6 to 12 months, but some people may stay on antidepressants for much longer.

What are the side effects of antidepressants?

Not everyone has side effects from antidepressants. But if you do have them, they're usually mild and may get better over time as your body gets used to the new medicine.

The most common side effects from antidepressants include:

  • Nausea and vomiting
  • Weight gain
  • Diarrhea
  • Sleepiness
  • Sexual problems, such as a lack of desire or ability to have sex

When thinking about side effects, it's important to remember that there are also risks from not treating depression. Your provider can help you think through the pros and cons of all your options.

If you have any side effects from antidepressants, your provider may suggest ways to manage them while you wait to see if the antidepressant will work. If the side effects bother you too much, you may need to change antidepressants. But you should never change your dose or stop taking an antidepressant on your own.

If you have serious problems or notice any changes that worry you, such as new or worsening symptoms, unusual changes in your mood, or you start acting differently, call your provider right away.

In some cases, children, teenagers, and young adults under 25 may be more likely to think about hurting or killing themselves when starting antidepressants or when the dose is changed. Get medical help right away if this happens.

What can I do to take antidepressants safely?

Antidepressants are generally safe when you use them correctly:

  • Tell your provider about everything you take. That includes medicines, herbs, supplements, and over-the-counter medicines you take, such as pain relievers and decongestants. Be honest about recreational drugs and alcohol, too.
  • Try to get all your medicines from the same pharmacy. That way the pharmacist can warn you and your provider if you take medicines that may cause problems when used together.
  • Follow all instructions about how to take your medicine.
  • Talk with your provider if side effects bother you.
  • Never stop taking antidepressants without your provider's help. Stopping too fast may make depression come back. You could even make your condition worse. To stop antidepressants safely, you need to give your body time to get used to being without the medicine. Your provider can tell you the safest way to go off an antidepressant.

NIH: National Institute of Mental Health


[Learn More in MedlinePlus]

Poisoning

A poison is any substance that is harmful to your body. You might swallow it, inhale it, inject it, or absorb it through your skin. Any substance can be poisonous if too much is taken. Poisons can include:

  • Prescription or over-the-counter medicines taken in doses that are too high
  • Overdoses of illegal drugs
  • Carbon monoxide from gas appliances
  • Household products, such as laundry powder or furniture polish
  • Pesticides
  • Indoor or outdoor plants
  • Metals such as lead and mercury

The effects of poisoning range from short-term illness to brain damage, coma, and death. To prevent poisoning it is important to use and store products exactly as their labels say. Keep dangerous products where children can't get to them. Treatment for poisoning depends on the type of poison. If you suspect someone has been poisoned, call your local poison control center at 1-800-222-1222 right away.


[Learn More in MedlinePlus]

Code History

  • FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
  • FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
  • FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.