T43.655A: Adverse effect of methamphetamines, initial encounter
T43.655A, adverse effect of methamphetamines, initial encounter, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 24 HCPCS Level II codes, including J0461 (Injection, atropine sulfate, 0.01 mg), J0153 (Injection, adenosine, 1 mg (not to be used to report any…), J1250 (Injection, dobutamine hydrochloride, per 250 mg). The articles come from 2 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with T43.655A as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| J0461 | Injection, atropine sulfate, 0.01 mg | Special coverage instructions apply | — | 2 |
| J0153 | Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds) | Special coverage instructions apply | — | 2 |
| J1250 | Injection, dobutamine hydrochloride, per 250 mg | Special coverage instructions apply | — | 2 |
| J0280 | Injection, aminophyllin, up to 250 mg | Special coverage instructions apply | — | 2 |
| J1245 | Injection, dipyridamole, per 10 mg | Special coverage instructions apply | — | 2 |
| A9700 | Supply of injectable contrast material for use in echocardiography, per study | Special coverage instructions apply | — | 2 |
| G0152 | Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0155 | Services of clinical social worker in home health or hospice settings, each 15 minutes | Carrier judgment | — | 1 |
| G0156 | Services of home health/hospice aide in home health or hospice settings, each 15 minutes | Carrier judgment | — | 1 |
| G0299 | Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0300 | Direct skilled nursing services of a licensed practical nurse (lpn) in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| J2785 | Injection, regadenoson, 0.1 mg | Carrier judgment | — | 1 |
| J3490 | Unclassified drugs | Special coverage instructions apply | — | 1 |
| Q9957 | Injection, perflutren lipid microspheres, per ml | Carrier judgment | — | 1 |
| Q9956 | Injection, octafluoropropane microspheres, per ml | Carrier judgment | — | 1 |
| C9399 | Unclassified drugs or biologicals | Special coverage instructions apply | — | 1 |
| C8921 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; complete | Special coverage instructions apply | — | 1 |
| C8922 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; follow-up or limited study | Special coverage instructions apply | — | 1 |
| C8923 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, without spectral or color doppler echocardiography | Special coverage instructions apply | — | 1 |
| C8924 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, follow-up or limited study | Special coverage instructions apply | — | 1 |
| C8928 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report | Special coverage instructions apply | — | 1 |
| C8929 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography | Special coverage instructions apply | — | 1 |
| C8930 | Transthoracic echocardiography, with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuous electrocardiographic monitoring, with physician supervision | Special coverage instructions apply | — | 1 |
| Q9955 | Injection, perflexane lipid microspheres, per ml | Carrier judgment | — | 1 |
Medicare policy articles listing T43.655A
- A56756: Billing and Coding: Home Health - Psychiatric Care (Palmetto GBA (HHH MAC); 5 Level II codes). LCD with the same title: L34561
- A57306: Billing and Coding: Transthoracic Echocardiography (TTE) (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 19 Level II codes). LCD with the same title: L33577, L34338
- A56625: Billing and Coding: Echocardiography (Palmetto GBA (MAC - Part A, MAC - Part B); 6 Level II codes). LCD with the same title: L37379
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other T43 diagnoses (Poisoning by, adverse effect of and underdosing of psychotropic drugs, not elsewhere classified)
- T43.651A — Poisoning by methamphetamines accidental (unintentional), initial…
- T43.652A — Poisoning by methamphetamines intentional self-harm, initial encounter
- T43.653A — Poisoning by methamphetamines, assault, initial encounter
- T43.654A — Poisoning by methamphetamines, undetermined, initial encounter
- T43.656A — Underdosing of methamphetamines, initial encounter
- T43.601A — Poisoning by unspecified psychostimulants, accidental…
- T43.602A — Poisoning by unspecified psychostimulants, intentional self-harm…
- T43.603A — Poisoning by unspecified psychostimulants, assault, initial encounter
- T43.604A — Poisoning by unspecified psychostimulants, undetermined, initial…
- T43.611A — Poisoning by caffeine, accidental (unintentional), initial encounter
- T43.612A — Poisoning by caffeine, intentional self-harm, initial encounter
- T43.613A — Poisoning by caffeine, assault, initial encounter
- T43.614A — Poisoning by caffeine, undetermined, initial encounter
- T43.615A — Adverse effect of caffeine, initial encounter
- T43.621A — Poisoning by amphetamines, accidental (unintentional), initial…
- T43.622A — Poisoning by amphetamines, intentional self-harm, initial encounter
- T43.623A — Poisoning by amphetamines, assault, initial encounter
- T43.624A — Poisoning by amphetamines, undetermined, initial encounter
- T43.625A — Adverse effect of amphetamines, initial encounter
- T43.631A — Poisoning by methylphenidate, accidental (unintentional), initial…
- T43.632A — Poisoning by methylphenidate, intentional self-harm, initial encounter
- T43.633A — Poisoning by methylphenidate, assault, initial encounter
- T43.634A — Poisoning by methylphenidate, undetermined, initial encounter
- T43.635A — Adverse effect of methylphenidate, initial encounter
- T43.641A — Poisoning by ecstasy, accidental (unintentional), initial encounter
- T43.642A — Poisoning by ecstasy, intentional self-harm, initial encounter
- T43.643A — Poisoning by ecstasy, assault, initial encounter
- T43.644A — Poisoning by ecstasy, undetermined, initial encounter
- T43.691A — Poisoning by other psychostimulants, accidental (unintentional)…
- T43.692A — Poisoning by other psychostimulants, intentional self-harm, initial…
Frequently asked questions
Does Medicare cover T43.655A (Adverse effect of methamphetamines, initial encounter)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list T43.655A as a covered diagnosis for 24 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 T43.655A?
The Level II codes from the policies most specific to this diagnosis are J0461 (Injection, atropine sulfate, 0.01 mg, 2 articles); J0153 (Injection, adenosine, 1 mg (not to be used to report any…, 2 articles); J1250 (Injection, dobutamine hydrochloride, per 250 mg, 2 articles); J0280 (Injection, aminophyllin, up to 250 mg, 2 articles); J1245 (Injection, dipyridamole, per 10 mg, 2 articles). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list T43.655A?
A56756 (Billing and Coding: Home Health - Psychiatric Care); A57306 (Billing and Coding: Transthoracic Echocardiography (TTE)); A56625 (Billing and Coding: Echocardiography).
What is ICD-10-CM code T43.655A?
T43.655A is the ICD-10-CM code for adverse effect of methamphetamines, initial encounter, in category T43 (Poisoning by, adverse effect of and underdosing of psychotropic drugs, not elsewhere classified), chapter 19: Injury, poisoning and other consequences of external causes.
Next steps
- Run a reimbursement report for a device billed under J0461
- Watch J0461 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0461
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 19: Injury, poisoning and other consequences of external causes · All diagnoses · HCPCS lookup