2027 ICD-10-CM Diagnosis Code T43.225SAdverse effect of selective serotonin reuptake inhibitors, sequela

ICD-10-CM Codes›S00–T88›T36-T50›T43

ICD-10-CM T43.225S
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

T43.225S is a billable ICD-10-CM diagnosis code for adverse effect of selective serotonin reuptake inhibitors, 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 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 922 through 923. The code is not accepted as a principal diagnosis by the Medicare Code Editor and exempt from POA reporting. Coders also document this condition as citalopram adverse reaction. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Poisoning/toxic effect/adverse effects/underdosing, sequela.

Code Identity

ICD-10-CM Code
T43.225S
Billable Status
Yes — Valid for Submission
Code Describes
Adverse effect of selective serotonin reuptake inhibitors, sequela
Short Description
Adverse effect of slctv serotonin reuptake inhibtr, sequela
Parent Code
Adverse effect of selective serotonin reuptake inhibitors

Code Classification

ChapterS00–T88Injury, poisoning and certain other consequences of external causes
SectionT36-T50Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances
CategoryT43Poisoning by, adverse effect of and underdosing of psychotropic drugs, not elsewhere classified
This CodeT43.225SAdverse effect of selective serotonin reuptake inhibitors, sequela

Code EditsBilling

Medicare Code Editor checks that affect claim validity for T43.225S.

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)Billing

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Citalopram adverse reaction
  • Fluoxetine adverse reaction
  • Fluvoxamine adverse reaction
  • Nefazodone adverse reaction
  • Paroxetine adverse reaction
  • Post selective serotonin re-uptake inhibitor sexual dysfunction
  • Selective serotonin re-uptake inhibitor adverse reaction
  • Sertraline adverse reaction
  • Sexual dysfunction caused by drug
  • Sexual dysfunction caused by psychoactive substance

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 2027, published by CMS and the National Center for Health Statistics.

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to T43.225S: its own notes plus those printed at T43, block T36-T50, and Chapter 19. A note printed at a category, block or chapter applies to every code under it.

Includes

Further defines, or gives examples of, the content of the category.

From Block T36-T50 Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances applies to 3,186 codes
  • adverse effect of correct substance properly administered
  • poisoning by overdose of substance
  • poisoning by wrong substance given or taken in error
  • underdosing by (inadvertently) (deliberately) taking less substance than prescribed or instructed

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From Block T36-T50 Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances applies to 3,186 codes
  • toxic reaction to local anesthesia in pregnancy (O29.3-)

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From T43 Poisoning by, adverse effect of and underdosing of psychotropic drugs, not elsewhere classified applies to 354 codes
  • appetite depressants (T50.5-)
  • barbiturates (T42.3-)
  • benzodiazepines (T42.4-)
  • drug dependence and related mental and behavioral disorders due to psychoactive substance use (F10.- -F19.-)
  • methaqualone (T42.6-)
  • psychodysleptics [hallucinogens] (T40.7-T40.9-)
From Block T36-T50 Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances applies to 3,186 codes
  • abuse and dependence of psychoactive substances (F10-F19)
  • abuse of non-dependence-producing substances (F55.-)
  • immunodeficiency due to drugs (D84.821)
  • drug reaction and poisoning affecting newborn (P00-P96)
  • pathological drug intoxication (inebriation) (F10-F19)
From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes

Code First

The underlying condition named in the note is sequenced before this code.

From Block T36-T50 Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances applies to 3,186 codes
  • for adverse effects, the nature of the adverse effect, such as:
  • adverse effect NOS (T88.7)
  • aspirin gastritis (K29.-)
  • blood disorders (D56-D76)
  • contact dermatitis (L23-L25)
  • dermatitis due to substances taken internally (L27.-)
  • nephropathy (N14.0-N14.2)

Use Additional Code

Add a second code, after this one, to fully describe the condition.

From Block T36-T50 Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances applies to 3,186 codes
  • code(s) to specify:
  • manifestations of poisoning
  • underdosing or failure in dosage during medical and surgical care (Y63.6, Y63.8-Y63.9)
  • underdosing of medication regimen (Z91.12-, Z91.13-)
From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes
  • code to identify any retained foreign body, if applicable (Z18.-)

Notes

General instructions on how these codes are used.

From Block T36-T50 Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances applies to 3,186 codes
  • The drug giving rise to the adverse effect should be identified by use of codes from categories T36-T50 with fifth or sixth character 5.
From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes
  • Use secondary code(s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code
  • The chapter uses the S-section for coding different types of injuries related to single body regions and the T-section to cover injuries to unspecified body regions as well as poisoning and certain other consequences of external causes.

7th Character

Every code in the category takes a 7th character from the listed values, with the placeholder X filling any empty positions before it.

From T43 Poisoning by, adverse effect of and underdosing of psychotropic drugs, not elsewhere classified applies to 354 codes
  • The appropriate 7th character is to be added to each code from category T43
  • Ainitial encounter
  • Dsubsequent encounter
  • Ssequela this code

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name T43.225S, its category, or a range that includes it.

Code First 1

These codes say to code first a condition named in the note, and T43.225S is one of the conditions named.

  • G90.81 Serotonin syndrome
    selective serotonin reuptake inhibitors [SSRI] (T43.22 with sixth character 1-4) names T43.22, which includes this code

Use Additional Code 1

These codes say to use an additional code from the note, and T43.225S is one of the codes named.

  • G90.81 Serotonin syndrome
    selective serotonin reuptake inhibitors [SSRI] (T43.225) names T43.225, which includes this code

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR INJ075
Poisoning/toxic effect/adverse effects/underdosing, sequela
Default principal diagnosis: inpatient No · outpatient Yes

Clinical InformationClinical

  • Citalopram

    a furancarbonitrile that is one of the selective serotonin reuptake inhibitors used as an antidepressant. the drug is also effective in reducing ethanol uptake in alcoholics and is used in depressed patients who also suffer from tardive dyskinesia in preference to tricyclic antidepressants, which aggravate dyskinesia.
  • Fluoxetine

    the first highly specific serotonin uptake inhibitor. it is used as an antidepressant and often has a more acceptable side-effects profile than traditional antidepressants.
  • Fluvoxamine

    a selective serotonin reuptake inhibitor that is used in the treatment of depression and a variety of anxiety disorders.
  • Zimeldine

    one of the selective serotonin reuptake inhibitors formerly used for depression but was withdrawn worldwide in september 1983 because of the risk of guillain-barre syndrome associated with its use. (from martindale, the extra pharmacopoeia, 29th ed, p385)

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.

SubstanceAccidentalSelf-harmAssaultUndeter­minedAdverse
Effect
Under­dosing
Antidepressant::selective serotonin reuptake inhibitorT43.221T43.222T43.223T43.224T43.225T43.226
CitalopramT43.221T43.222T43.223T43.224T43.225T43.226
FemoxetineT43.221T43.222T43.223T43.224T43.225T43.226
FluoxetineT43.221T43.222T43.223T43.224T43.225T43.226
FluvoxamineT43.221T43.222T43.223T43.224T43.225T43.226
IndalpineT43.221T43.222T43.223T43.224T43.225T43.226
ZimeldineT43.221T43.222T43.223T43.224T43.225T43.226

Patient EducationClinical

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.

The full article covers:

  • What is a drug interaction?
  • What are side effects?
  • What are drug allergies?
  • How can I stay safe when taking medicines?

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert T43.225S to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
909.5 Lte efct advrs efct drug
ApproximateCombination The match is approximate, and more than one code can be needed to describe the source diagnosis. Confirm with contextual judgment.
ICD-9-CM
E939.0 Adv eff antidepressants
ApproximateCombination The match is approximate, and more than one code can be needed to describe the source diagnosis. Confirm with contextual judgment.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About T43.225SOverview

What is the ICD-10 code for adverse effect of selective serotonin reuptake inhibitors, sequela?

The ICD-10-CM code for adverse effect of selective serotonin reuptake inhibitors, sequela is T43.225S (sometimes written as T43225S). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is T43.225S (Adverse effect of selective serotonin reuptake inhibitors) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report adverse effect of selective serotonin reuptake inhibitors, sequela on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What does the 7th character S in T43.225S mean?

The final character S makes this a sequela code: it reports a lingering problem that remains after the adverse effect of selective serotonin reuptake inhibitors itself has resolved, not the original event.

What MS-DRG does T43.225S group to?

On inpatient claims, adverse effect of selective serotonin reuptake inhibitors, sequela maps to MS-DRG 923, 922, with relative weights from 0.9980 to 1.6248 depending on complications. Higher weights mean higher Medicare reimbursement.

Can T43.225S be a principal diagnosis?

No. The Medicare Code Editor rejects this code as a principal diagnosis because adverse effect of selective serotonin reuptake inhibitors, sequela describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.