2026 ICD-10-CM Diagnosis Code T43.4X6AUnderdosing of butyrophenone and thiothixene neuroleptics, initial encounter
T43.4X6A is a billable ICD-10-CM diagnosis code for underdosing of butyrophenone and thiothixene neuroleptics, 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 T43.4X6A.
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 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
Benperidol
a butyrophenone with general properties similar to those of haloperidol. it has been used in the treatment of aberrant sexual behavior. (from martindale, the extra pharmacopoeia, 30th ed, p567)Chlorprothixene
a thioxanthine with effects similar to the phenothiazine antipsychotics.Clopenthixol
a thioxanthene with therapeutic actions similar to the phenothiazine antipsychotics. it is an antagonist at d1 and d2 dopamine receptors.Flupenthixol
a thioxanthene neuroleptic that, unlike chlorpromazine, is claimed to have cns-activating properties. it is used in the treatment of psychoses although not in excited or manic patients. (from martindale, the extra pharmacopoeia, 30th ed, p595)Haloperidol
a phenyl-piperidinyl-butyrophenone that is used primarily to treat schizophrenia and other psychoses. it is also used in schizoaffective disorder, delusional disorders, ballism, and tourette syndrome (a drug of choice) and occasionally as adjunctive therapy in intellectual disability and the chorea of huntington disease. it is a potent antiemetic and is used in the treatment of intractable hiccups. (from ama drug evaluations annual, 1994, p279)Spiperone
a spiro butyrophenone analog similar to haloperidol and other related compounds. it has been recommended in the treatment of schizophrenia.Thiothixene
a thioxanthine used as an antipsychotic agent. its effects are similar to the phenothiazine antipsychotics.Trifluperidol
a butyrophenone with general properties similar to those of haloperidol. it is used in the treatment of psychoses including mania and schizophrenia. (from martindale, the extra pharmacopoeia, 30th ed, p621)
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 T43.4X6A to ICD-9-CMHistory
Code HistoryHistory
Questions About T43.4X6AOverview
Is T43.4X6A (Underdosing of butyrophenone and thiothixene neuroleptics) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report underdosing of butyrophenone and thiothixene neuroleptics, initial encounter on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character A in T43.4X6A mean?
The final character A marks the initial encounter: use it while the patient is receiving active treatment for underdosing of butyrophenone and thiothixene neuroleptics, such as an emergency visit or first evaluation.
Can T43.4X6A be a principal diagnosis?
No. The Medicare Code Editor rejects this code as a principal diagnosis because underdosing of butyrophenone and thiothixene neuroleptics, 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.
