T79 — Certain early complications of trauma
ICD-10-CM codes T79 cover certain early complications of trauma, within injury, poisoning and certain other consequences of external causes. The block holds 76 codes across 1 category, of which 54 are billable and 22 are header codes that cannot be submitted on a claim. 76 of them (100%) require a 7th character.
The 7th character in T79
A code in this block is not complete without its 7th character, and a missing one is a rejected claim rather than a denied one: the clearinghouse never passes it on. 76 of the 76 codes here take one.
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment in T79
0 codes in this block map to a CMS-HCC, which means the diagnosis carries a risk-adjustment payment when it is documented and coded. Under-coding here is money left on the table; over-coding here is what audits are for.
- HCC 267 Deep Vein Thrombosis and Pulmonary Embolism
- HCC 2 Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock
What else to watch in T79
- 16 codes are laterality-specific. They come in left and right pairs, and the pair is mutually exclusive on a single site: coding both without a bilateral code is a contradiction a scrubber should catch before the payer does.
- 44 codes are named in Medicare coverage policies. An LCD or NCD lists them as supporting medical necessity, or explicitly as not supporting it. Which applies depends on the MAC for your state.