2024 ICD-10-CM Diagnosis Code T43.3X5D

Adverse effect of phenothiazine antipsychotics and neuroleptics, subsequent encounter

ICD-10-CM Code:
T43.3X5D
ICD-10 Code for:
Adverse effect of phenothiazine antipsychot/neurolept, subs
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)

T43.3X5D is a billable diagnosis code used to specify a medical diagnosis of adverse effect of phenothiazine antipsychotics and neuroleptics, subsequent 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. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

This code describes a circumstance which influences the patient's health status but not a current illness or injury. The code is unacceptable as a principal diagnosis.

T43.3X5D is a subsequent encounter code, includes a 7th character and should be used after the patient has completed active treatment for a condition like adverse effect of phenothiazine antipsychotics and neuroleptics. According to ICD-10-CM Guidelines a "subsequent encounter" occurs when the patient is receiving routine care for the condition during the healing or recovery phase of treatment. Subsequent diagnosis codes are appropriate during the recovery phase, no matter how many times the patient has seen the provider for this condition. If the provider needs to adjust the patient's care plan due to a setback or other complication, the encounter becomes active again.

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • Alimemazine adverse reaction
  • Chlorpromazine adverse reaction
  • Chlorpromazine pigmentation
  • Drug pigmentation
  • Fluphenazine adverse reaction
  • Fluphenazine decanoate adverse reaction
  • Fluphenazine enanthate adverse reaction
  • Levomepromazine adverse reaction
  • Mequitazine adverse reaction
  • Pericyazine adverse reaction
  • Perphenazine adverse reaction
  • Phenothiazine adverse reaction
  • Pipothiazine adverse reaction
  • Prochlorperazine adverse reaction
  • Promazine adverse reaction
  • Promethazine adverse reaction
  • Retinopathy caused by trifluoperazine
  • Thiethylperazine adverse reaction
  • Thioridazine adverse reaction
  • Thioridazine adverse reaction
  • Thioridazine retinopathy
  • Trifluoperazine adverse reaction
  • Trifluoperazine adverse reaction

Clinical Classification

Clinical Information

  • Acepromazine

    a phenothiazine that is used in the treatment of psychoses.
  • Chlorpromazine

    the prototypical phenothiazine antipsychotic drug. like the other drugs in this class chlorpromazine's antipsychotic actions are thought to be due to long-term adaptation by the brain to blocking dopamine receptors. chlorpromazine has several other actions and therapeutic uses, including as an antiemetic and in the treatment of intractable hiccup.
  • Fluphenazine

    a phenothiazine used in the treatment of psychoses. its properties and uses are generally similar to those of chlorpromazine.
  • Mesoridazine

    a phenothiazine antipsychotic with effects similar to chlorpromazine.
  • Methotrimeprazine

    a phenothiazine with pharmacological activity similar to that of both chlorpromazine and promethazine. it has the histamine-antagonist properties of the antihistamines together with central nervous system effects resembling those of chlorpromazine. (from martindale, the extra pharmacopoeia, 30th ed, p604)
  • Perazine

    a phenothiazine antipsychotic with actions and uses similar to those of chlorpromazine. extrapyramidal symptoms may be more common than other side effects.
  • Perphenazine

    an antipsychotic phenothiazine derivative with actions and uses similar to those of chlorpromazine.
  • Prochlorperazine

    a phenothiazine antipsychotic used principally in the treatment of nausea; vomiting; and vertigo. it is more likely than chlorpromazine to cause extrapyramidal disorders. (from martindale, the extra pharmacopoeia, 30th ed, p612)
  • Promazine

    a phenothiazine with actions similar to chlorpromazine but with less antipsychotic activity. it is primarily used in short-term treatment of disturbed behavior and as an antiemetic.
  • Thiethylperazine

    a dopamine antagonist that is particularly useful in treating the nausea and vomiting associated with anesthesia, mildly emetic cancer chemotherapy agents, radiation therapy, and toxins. this piperazine phenothiazine does not prevent vertigo or motion sickness. (from ama drug evaluations annual, 1994, p457)
  • Thioridazine

    a phenothiazine antipsychotic used in the management of phycoses, including schizophrenia.
  • Trifluoperazine

    a phenothiazine with actions similar to chlorpromazine. it is used as an antipsychotic and an antiemetic.
  • Triflupromazine

    a phenothiazine used as an antipsychotic agent and as an antiemetic.

Coding Guidelines

When coding an adverse effect of a drug that has been correctly prescribed and properly administered, assign the appropriate code for the nature of the adverse effect followed by the appropriate code for the adverse effect of the drug.

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

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10-CM Code Edits are applicable to this code:

  • Unacceptable principal diagnosis - There are selected codes that describe a circumstance which influences an individual's health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.

Present on Admission (POA)

T43.3X5D is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here.

CMS POA Indicator Options and Definitions

POA IndicatorReason for CodeCMS will pay the CC/MCC DRG?
YDiagnosis was present at time of inpatient admission.YES
NDiagnosis was not present at time of inpatient admission.NO
UDocumentation insufficient to determine if the condition was present at the time of inpatient admission.NO
WClinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.YES
1Unreported/Not used - Exempt from POA reporting. NO

Convert T43.3X5D to ICD-9-CM

  • ICD-9-CM Code: V58.89 - Other specfied aftercare
    Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Table of Drugs and Chemicals

The parent code T43.3X5 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
AcepromazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
AcetophenazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
AlimemazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
ButaperazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
CarfenazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
CarphenazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
ChlorpromazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
CompazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
CyamemazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
DimetotiazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
DioxopromethazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
DixyrazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
FentazinT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
FluopromazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
FluphenazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
IsopromethazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
LargactilT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
LevomepromazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
LevopromazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
MellarilT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
MepazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
MequitazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
MesoridazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
MethdilazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
MethopromazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
MethotrimeprazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
MethoxypromazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
MetofenazateT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
OxomemazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
PecazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
PerazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
PericiazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
PerphenazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
Phenothiazine (psychotropic) NECT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
Phenothiazine (psychotropic) NEC
  »insecticide
T43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
PiperacetazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
PipotiazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
PlegicilT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
ProchlorperazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
PromazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
Promethazine (teoclate)T43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
Propylaminopheno-thiazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
SparineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
StelazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
StemetilT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
SulforidazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
Thiazinamium metilsulfateT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
ThiethylperazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
ThiopropazateT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
ThioproperazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
ThioridazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
ThorazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
TindalT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
TrifluoperazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6
TriflupromazineT43.3X1T43.3X2T43.3X3T43.3X4T43.3X5T43.3X6

Patient Education


Drug Reactions

Most of the time, medicines make our lives better. They reduce aches and pains, fight infections, and control problems such as high blood pressure or diabetes. But medicines can also cause unwanted reactions, such as drug interactions, side effects, and allergies.

What is a drug interaction?

A drug interaction is a change in the way a drug acts in the body when taken with certain other drugs, foods, or supplements or when taken while you have certain medical conditions. Examples include:

  • Two drugs, such as aspirin and blood thinners
  • Drugs and food, such as statins and grapefruit
  • Drugs and supplements, such as gingko and blood thinners
  • Drugs and medical conditions, such as aspirin and peptic ulcers

Interactions could cause a drug to be more or less effective, cause side effects, or change the way one or both drugs work.

What are side effects?

Side effects are unwanted, usually unpleasant, effects caused by medicines. Most are mild, such as a stomachache, dry mouth, or drowsiness, and go away after you stop taking the medicine. Others can be more serious. Sometimes a drug can interact with a disease that you have and cause a side effect. For example, if you have a heart condition, certain decongestants can cause you to have a rapid heartbeat.

What are drug allergies?

Drug allergies are another type of reaction. They can range from mild to life-threatening. Skin reactions, such as hives and rashes, are the most common type. Anaphylaxis, a serious allergic reaction, is less common.

How can I stay safe when taking medicines?

When you start a new prescription or over-the-counter medicine, make sure you understand how to take it correctly. Know which other medicines, foods, and supplements you need to avoid. Always talk to your health care provider or pharmacist if you have questions about your medicines.


[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.