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T43.024 vs T43.025

T43.024 (Poisoning by tetracyclic antidepressants, undetermined) compared with T43.025 (Adverse effect of tetracyclic antidepressants), from the official CMS tabular data. T43.024 and T43.025 code the same substance (Maprotiline) with a different intent.

Relationship

Informational

Drug table relationship

T43.024
Poisoning by tetracyclic antidepressants, undetermined
T43.025
Adverse effect of tetracyclic antidepressants

Same substance, different circumstance of exposure.

Same substance — adverse effect (Maprotiline)

Accidental poisoning, intentional self-harm, assault, undetermined intent, adverse effect and underdosing are mutually exclusive columns — exactly one applies to a given encounter.

Source: CMS Table of Drugs and Chemicals

Can these codes be reported together?

Same substance, different intent. T43.024 and T43.025 code the same substance (Maprotiline) with a different circumstance of exposure.

From the CMS Table of Drugs and Chemicals: accidental poisoning, intentional self-harm, assault, undetermined intent, adverse effect and underdosing are mutually exclusive columns — only one of them applies to a given encounter.

Side by side

T43.024Poisoning by tetracyclic antidepressants, undeterminedT43.025Adverse effect of tetracyclic antidepressants
Billing statusNon-billable headerNon-billable header
ClassificationS00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)
DefinitionPoisoning by tetracyclic antidepressants, undetermined is a non-billable ICD-10-CM category code (T43.024).Adverse effect of tetracyclic antidepressants is a non-billable ICD-10-CM category code (T43.025).
7th characterThe appropriate 7th character is to be added to each code from category T43The appropriate 7th character is to be added to each code from category T43
Includes
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
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
Use additional code
code(s) to specify:
manifestations of poisoning
underdosing or failure in dosage during medical and surgical care (Y63.6, Y63.8-Y63.9)
code(s) to specify:
manifestations of poisoning
underdosing or failure in dosage during medical and surgical care (Y63.6, Y63.8-Y63.9)
Code first
, for adverse effects, the nature of the adverse effect, such as:
adverse effect NOS (T88.7)
, for adverse effects, the nature of the adverse effect, such as:
adverse effect NOS (T88.7)

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources