2026 ICD-10-CM Diagnosis Code T43.015AAdverse effect of tricyclic antidepressants, initial encounter
T43.015A is a billable ICD-10-CM diagnosis code for adverse effect of tricyclic antidepressants, 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) and groups to MS-DRG 917 through 918. 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 Adverse effects of drugs and medicaments, initial encounter.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for T43.015A.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Amitriptyline adverse reaction
- Amoxapine adverse reaction
- Butriptyline adverse reaction
- Clomipramine adverse reaction
- Desipramine adverse reaction
- Dosulepin adverse reaction
- Doxepin adverse reaction
- Imipramine adverse reaction
- Iprindole adverse reaction
- Lofepramine adverse reaction
- Nortriptyline adverse reaction
- Protriptyline adverse reaction
- Tricyclic antidepressant drug adverse reaction
- Trimipramine adverse reaction
Coding GuidelinesGuidance
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 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 T43.015A to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About T43.015AOverview
Is T43.015A (Adverse effect of tricyclic antidepressants) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report adverse effect of tricyclic antidepressants, initial encounter on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character A in T43.015A mean?
The final character A marks the initial encounter: use it while the patient is receiving active treatment for adverse effect of tricyclic antidepressants, such as an emergency visit or first evaluation.
What MS-DRG does T43.015A group to?
On inpatient claims, adverse effect of tricyclic antidepressants, initial encounter maps to MS-DRG 917, 918, with relative weights from 0.8571 to 1.5684 depending on complications. Higher weights mean higher Medicare reimbursement.
Can T43.015A be a principal diagnosis?
No. The Medicare Code Editor rejects this code as a principal diagnosis because adverse effect of tricyclic antidepressants, initial encounter describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.
What is the ICD-9 equivalent of T43.015A?
Under the General Equivalence Mappings, adverse effect of tricyclic antidepressants, initial encounter converts to ICD-9-CM 995.29 (adv eff med/biol NEC/NOS) and E939.0 (adv eff antidepressants). 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.
