2026 ICD-10-CM Diagnosis Code T40.996AUnderdosing of other psychodysleptics [hallucinogens], initial encounter
T40.996A is a billable ICD-10-CM diagnosis code for underdosing of other psychodysleptics [hallucinogens], initial encounter. The 7th character A marks it as an initial encounter code, used while the patient is receiving active treatment. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026). The code is not accepted as a principal diagnosis by the Medicare Code Editor. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Underdosing of drugs and medicaments, initial encounter.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for T40.996A.
Coding GuidelinesGuidance
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 narcotics and psychodysleptics [hallucinogens] (T40). Use the following options for the applicable episode of care:
- A - initial encounter
- D - subsequent encounter
- S - sequela
Source: ICD-10-CM Official Guidelines for Coding and Reporting, FY 2026, published by CMS and the National Center for Health Statistics.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Phencyclidine
a hallucinogen formerly used as a veterinary anesthetic, and briefly as a general anesthetic for humans. phencyclidine is similar to ketamine in structure and in many of its effects. like ketamine, it can produce a dissociative state. it exerts its pharmacological action through inhibition of nmda receptors (receptors, n-methyl-d-aspartate). as a drug of abuse, it is known as pcp and angel dust.Phencyclidine Abuse
the misuse of phencyclidine with associated psychological symptoms and impairment in social or occupational functioning.Receptors, Phencyclidine
specific sites or molecular structures on cell membranes or in cells with which phencyclidine reacts or to which it binds to elicit the specific response of the cell to phencyclidine. studies have demonstrated the presence of multiple receptor sites for pcp. these are the pcp/sigma site, which binds both pcp and psychotomimetic opiates but not certain antipsychotics, and the pcp site, which selectively binds pcp analogs.
Table of Drugs and ChemicalsClinical
Substances in the Table of Drugs and Chemicals that reference this code family. Always confirm in the Tabular List before coding.
Patient EducationClinical
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:
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert T40.996A to ICD-9-CMHistory
Code HistoryHistory
Questions About T40.996AOverview
Is T40.996A (Underdosing of other psychodysleptics [hallucinogens]) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report underdosing of other psychodysleptics [hallucinogens], initial encounter on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character A in T40.996A mean?
The final character A marks the initial encounter: use it while the patient is receiving active treatment for underdosing of other psychodysleptics [hallucinogens], such as an emergency visit or first evaluation.
Can T40.996A be a principal diagnosis?
No. The Medicare Code Editor rejects this code as a principal diagnosis because underdosing of other psychodysleptics [hallucinogens], initial encounter describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.
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.
