2027 ICD-10-CM Diagnosis Code T43.626AUnderdosing of amphetamines, initial encounter

ICD-10-CM Codes›S00–T88›T36-T50›T43

ICD-10-CM T43.626A
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

T43.626A is a billable ICD-10-CM diagnosis code for underdosing of amphetamines, 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 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 951. 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

ICD-10-CM Code
T43.626A
Billable Status
Yes — Valid for Submission
Code Describes
Underdosing of amphetamines, initial encounter
Short Description
Underdosing of amphetamines, initial encounter
Same as the full description in the CMS dataset.
Parent Code
T43.626
Underdosing of amphetamines

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 CodeT43.626AUnderdosing of amphetamines, initial encounter

Code EditsBilling

Medicare Code Editor checks that affect claim validity for T43.626A.

Unacceptable principal diagnosis
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.

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 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 T43.626A: its own notes plus those printed at T43.6, 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 T43.6 Poisoning by, adverse effect of and underdosing of psychostimulants applies to 120 codes
  • poisoning by, adverse effect of and underdosing of cocaine (T40.5-)
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
Values for category T43 Encounter: Initial, Subsequent, Sequela
  • Ainitial encounter this code
  • Dsubsequent encounter
  • Ssequela

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

Clinical ClassificationClinical

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

CCSR INJ029
Underdosing of drugs and medicaments, initial encounter
Default principal diagnosis: inpatient No · outpatient No

Clinical InformationClinical

  • Amphetamine

    a powerful central nervous system stimulant and sympathomimetic. amphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulation of release of monamines, and inhibiting monoamine oxidase. amphetamine is also a drug of abuse and a psychotomimetic. the l- and the d,l-forms are included here. the l-form has less central nervous system activity but stronger cardiovascular effects. the d-form is dextroamphetamine.

  • Dextroamphetamine

    the d-form of amphetamine. it is a central nervous system stimulant and a sympathomimetic. it has also been used in the treatment of narcolepsy and of attention deficit disorders and hyperactivity in children. dextroamphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulating release of monamines, and inhibiting monoamine oxidase. it is also a drug of abuse and a psychotomimetic.

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
AmfetamineT43.621T43.622T43.623T43.624T43.625T43.626
AmfetaminilT43.621T43.622T43.623T43.624T43.625T43.626
Amphetamine NECT43.621T43.622T43.623T43.624T43.625T43.626
Benzedrine (amphetamine)T43.621T43.622T43.623T43.624T43.625T43.626
Central nervous system::stimulants::amphetaminesT43.621T43.622T43.623T43.624T43.625T43.626
DexamfetamineT43.621T43.622T43.623T43.624T43.625T43.626
DexamphetamineT43.621T43.622T43.623T43.624T43.625T43.626
DexedrineT43.621T43.622T43.623T43.624T43.625T43.626
DextroamphetamineT43.621T43.622T43.623T43.624T43.625T43.626
MethylenedioxyamphetamineT43.621T43.622T43.623T43.624T43.625T43.626
Psychostimulant::amphetamineT43.621T43.622T43.623T43.624T43.625T43.626
TenamfetamineT43.621T43.622T43.623T43.624T43.625T43.626

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 T43.626A to ICD-9-CMHistory

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

ICD-9-CM
No Map There is no ICD-9 equivalent for this code.

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 T43.626AOverview

What is the ICD-10 code for underdosing of amphetamines, initial encounter?

The ICD-10-CM code for underdosing of amphetamines, initial encounter is T43.626A (sometimes written as T43626A). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is T43.626A (Underdosing of amphetamines) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report underdosing of amphetamines, initial encounter on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What does the 7th character A in T43.626A mean?

The final character A marks the initial encounter: use it while the patient is receiving active treatment for underdosing of amphetamines, such as an emergency visit or first evaluation.

What MS-DRG does T43.626A group to?

On inpatient claims, underdosing of amphetamines, initial encounter maps to MS-DRG 951 (other Factors Influencing Health Status), which carries a relative weight of 0.5574. Higher weights mean higher Medicare reimbursement.

Can T43.626A be a principal diagnosis?

No. The Medicare Code Editor rejects this code as a principal diagnosis because underdosing of amphetamines, initial encounter describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.