2024 ICD-10-CM Diagnosis Code T43.616D

Underdosing of caffeine, subsequent encounter

ICD-10-CM Code:
T43.616D
ICD-10 Code for:
Underdosing of caffeine, subsequent encounter
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)

T43.616D is a billable diagnosis code used to specify a medical diagnosis of underdosing of caffeine, 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.

T43.616D is a subsequent encounter code, includes a 7th character and should be used after the patient has completed active treatment for a condition like underdosing of caffeine. 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.

Clinical Classification

Clinical Information

  • Caffeine

    a methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. caffeine's most notable pharmacological effect is as a central nervous system stimulant, increasing alertness and producing agitation. it also relaxes smooth muscle, stimulates cardiac muscle, stimulates diuresis, and appears to be useful in the treatment of some types of headache. several cellular actions of caffeine have been observed, but it is not entirely clear how each contributes to its pharmacological profile. among the most important are inhibition of cyclic nucleotide phosphodiesterases, antagonism of adenosine receptors, and modulation of intracellular calcium handling.
  • Cytochrome P-450 CYP1A2

    a cytochrome p450 enzyme subtype that has specificity for relatively planar heteroaromatic small molecules, such as caffeine and acetaminophen.

Coding Guidelines

Underdosing refers to taking less of a medication than is prescribed by a provider or a manufacturer's instruction. Codes for underdosing should never be assigned as principal or first-listed codes. If a patient has a relapse or exacerbation of the medical condition for which the drug is prescribed because of the reduction in dose, then the medical condition itself should be coded.

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)

T43.616D 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 T43.616D to ICD-9-CM

  • ICD-9-CM Code: -
    No Map Flag -

Table of Drugs and Chemicals

The parent code T43.616 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
CaffeineT43.611T43.612T43.613T43.614T43.615T43.616

Patient Education


Caffeine

What is caffeine?

Caffeine is a bitter substance that occurs naturally in more than 60 plants including:

  • Coffee beans
  • Tea leaves
  • Kola nuts, which are used to flavor soft drink colas
  • Cacao pods, which are used to make chocolate products

There is also synthetic (man-made) caffeine, which is added to some medicines, foods, and drinks. For example, some pain relievers, cold medicines, and over-the-counter medicines for alertness contain synthetic caffeine. So do energy drinks and "energy-boosting" gums and snacks.

Most people consume caffeine from drinks. The amount of caffeine in different drinks can vary a lot, but it is generally:

  • An 8-ounce cup of coffee: 95-200 mg
  • A 12-ounce can of cola: 35-45 mg
  • An 8-ounce energy drink: 70-100 mg
  • An 8-ounce cup of tea: 14-60 mg

What are caffeine's effects on the body?

Caffeine has many effects on your body's metabolism. It:

  • Stimulates your central nervous system, which can make you feel more awake and give you a boost of energy
  • Is a diuretic, meaning that it helps your body get rid of extra salt and water by urinating more
  • Increases the release of acid in your stomach, sometimes leading to an upset stomach or heartburn
  • May interfere with the absorption of calcium in the body
  • Increases your blood pressure

Within one hour of eating or drinking caffeine, it reaches its peak level in your blood. You may continue to feel the effects of caffeine for four to six hours.

What are the side effects from too much caffeine?

For most people, it is not harmful to consume up to 400mg of caffeine a day. If you do eat or drink too much caffeine, it can cause health problems, such as:

  • Restlessness and shakiness
  • Insomnia
  • Headaches
  • Dizziness
  • Fast heart rate
  • Dehydration
  • Anxiety
  • Dependency, so you need to take more of it to get the same results

Some people are more sensitive to the effects of caffeine than others.

What are energy drinks, and why can they be a problem?

Energy drinks are beverages that have added caffeine. The amount of caffeine in energy drinks can vary widely, and sometimes the labels on the drinks do not give you the actual amount of caffeine in them. Energy drinks may also contain sugars, vitamins, herbs, and supplements.

Companies that make energy drinks claim that the drinks can increase alertness and improve physical and mental performance. This has helped make the drinks popular with American teens and young adults. There's limited data showing that energy drinks might temporarily improve alertness and physical endurance. There is not enough evidence to show that they enhance strength or power. But what we do know is that energy drinks can be dangerous because they have large amounts of caffeine. And since they have lots of sugar, they can contribute to weight gain and worsen diabetes.

Sometimes young people mix their energy drinks with alcohol. It is dangerous to combine alcohol and caffeine. Caffeine can interfere with your ability to recognize how drunk you are, which can lead you to drink more. This also makes you more likely to make bad decisions.

Who should avoid or limit caffeine?

You should check with your health care provider about whether you should limit or avoid caffeine if you:

  • Are pregnant, since caffeine passes through the placenta to your baby.
  • Are breastfeeding, since a small amount of caffeine that you consume is passed along to your baby.
  • Have sleep disorders, including insomnia.
  • Have migraines or other chronic headaches.
  • Have anxiety.
  • Have GERD or ulcers.
  • Have arrhythmia (a problem with the rate or rhythm of your heartbeat).
  • Have high blood pressure.
  • Take certain medicines or supplements, including stimulants, certain antibiotics, asthma medicines, and heart medicines. Check with your health care provider about whether there might be interactions between caffeine and any medicines and supplements that you take.
  • Are a child or teen. Neither should have as much caffeine as adults. Children can be especially sensitive to the effects of caffeine.

What is caffeine withdrawal?

If you have been consuming caffeine on a regular basis and then suddenly stop, you may have caffeine withdrawal. Symptoms can include:

  • Headaches
  • Drowsiness
  • Irritability
  • Nausea
  • Trouble concentrating

These symptoms usually go away after a couple of days.


[Learn More in MedlinePlus]

Medication Errors

Medicines treat infectious diseases, prevent problems from chronic diseases, and ease pain. But medicines can also cause harmful reactions if not used correctly. Errors can happen in the hospital, at the health care provider's office, at the pharmacy, or at home. You can help prevent errors by:

  • Knowing your medicines. When you get a prescription, ask the name of the medicine and check to make sure that the pharmacy gave you the right medicine. Make sure that you understand how often you should take the medicine and how long you should take it.
  • Keeping a list of medicines.
    • Write down all of the medicines that you are taking, including the names of your medicines, how much you take, and when you take them. Make sure to include any over-the-counter medicines, vitamins, supplements, and herbs that you take.
    • List the medicines that you are allergic to or that have caused you problems in the past.
    • Take this list with you every time you see a health care provider.
  • Reading medicine labels and following the directions. Don't just rely on your memory - read the medication label every time. Be especially careful when giving medicines to children.
  • Asking questions. If you don't know the answers to these questions, ask your health care provider or pharmacist:
    • Why am I taking this medicine?
    • What are the common side effects?
    • What should I do if I have side effects?
    • When should I stop this medicine?
    • Can I take this medicine with the other medicines and supplements on my list?
    • Do I need to avoid certain foods or alcohol while taking this medicine?

Food and Drug Administration


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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.