2026 ICD-10-CM Diagnosis Code T43.011SPoisoning by tricyclic antidepressants, accidental (unintentional), sequela
T43.011S is a billable ICD-10-CM diagnosis code for poisoning by tricyclic antidepressants, accidental (unintentional), sequela. The 7th character S marks it as a sequela code, which reports a problem that remains after the original condition has resolved. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 922 through 923. The code is exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Poisoning/toxic effect/adverse effects/underdosing, sequela.
Code Identity
Code Classification
Present on Admission (POA)Billing
T43.011S is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Accidental amitriptyline overdose
- Accidental amoxapine overdose
- Accidental amoxapine poisoning
- Accidental butriptyline overdose
- Accidental butriptyline poisoning
- Accidental clomipramine overdose
- Accidental clomipramine poisoning
- Accidental desipramine overdose
- Accidental desipramine poisoning
- Accidental dosulepin overdose
- Accidental dosulepin poisoning
- Accidental doxepin overdose
- Accidental doxepin poisoning
- Accidental imipramine overdose
- Accidental iprindole overdose
- Accidental iprindole poisoning
- Accidental lofepramine overdose
- Accidental lofepramine poisoning
- Accidental nortriptyline overdose
- Accidental nortriptyline poisoning
- Accidental overdose of tricyclic antidepressant
- Accidental poisoning by amitriptyline
- Accidental poisoning by imipramine
- Accidental protriptyline overdose
- Accidental protriptyline poisoning
- Accidental trimipramine overdose
- Accidental trimipramine poisoning
- Acute tricyclic antidepressant poisoning
- Amitriptyline overdose
- Amoxapine overdose
- Amoxapine poisoning
- Butriptyline overdose
- Butriptyline poisoning
- Clomipramine overdose
- Clomipramine poisoning
- Desipramine overdose
- Desipramine poisoning
- Dosulepin overdose
- Dosulepin poisoning
- Doxepin overdose
- Doxepin poisoning
- Imipramine overdose
- Iprindole overdose
- Iprindole poisoning
- Lofepramine overdose
- Lofepramine poisoning
- Nortriptyline overdose
- Nortriptyline poisoning
- Overdose of tricyclic antidepressant
- Poisoning by amitriptyline
- Poisoning by imipramine
- Protriptyline overdose
- Protriptyline poisoning
- Tricyclic antidepressant poisoning
- Trimipramine overdose
- Trimipramine poisoning
Coding GuidelinesGuidance
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 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
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.
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
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.
The full article covers:
- What are antidepressants?
- Are antidepressants used for other conditions?
- What are the different types of antidepressants?
- Which type of antidepressant is right for me?
- How long do antidepressants take to work?
- How long will I need to take an antidepressant?
- What are the side effects of antidepressants?
- What can I do to take antidepressants safely?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert T43.011S to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About T43.011SOverview
Is T43.011S a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report poisoning by tricyclic antidepressants, accidental (unintentional), sequela on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character S in T43.011S mean?
The final character S makes this a sequela code: it reports a lingering problem that remains after the poisoning by tricyclic antidepressants, accidental (unintentional) itself has resolved, not the original event.
What MS-DRG does T43.011S group to?
When poisoning by tricyclic antidepressants, accidental (unintentional), sequela is the principal diagnosis on an inpatient stay, it groups to MS-DRG 922, 923, with relative weights from 1.0177 to 1.7494 depending on complications. Higher weights mean higher Medicare reimbursement.
Is T43.011S exempt from POA reporting?
Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for poisoning by tricyclic antidepressants, accidental (unintentional), sequela on inpatient claims.
What is the ICD-9 equivalent of T43.011S?
Under the General Equivalence Mappings, poisoning by tricyclic antidepressants, accidental (unintentional), sequela converts to ICD-9-CM 909.0 (late eff drug poisoning) and E929.2 (late eff acc poisoning). The mapping is approximate, so confirm the match fits the documentation.
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.
