Is T81.3 a billable ICD-10-CM code?

No. T81.3 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does T81.3 sit in the tabular list?

Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Complications of surgical and medical care, not elsewhere classified (T80-T88).

What cannot be coded together with T81.3?

T81.3 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

T81.3

T81.3 — Disruption of wound, not elsewhere classified

Non-billable headerICD-10-CM

T81.3 is a non-billable header ICD-10-CM code for disruption of wound, not elsewhere classified. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.

This code requires a 7th character

The appropriate 7th character is to be added to each code from category T81

A: initial encounter
D: subsequent encounter
S: sequela

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

breakdown (mechanical) of permanent sutures (T85.612)
displacement of permanent sutures (T85.622)
disruption of cesarean delivery wound (O90.0)
disruption of perineal obstetric wound (O90.1)
mechanical complication of permanent sutures NEC (T85.692)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Disruption of any suture materials or other closure methods

Risk adjustment

T81.3 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Code to one of these instead T81.3

4 child codes. Green means billable.

Related codes at this level

Codes that share T81. If T81.3 is not quite right, the correct code is usually one of these.

Questions about T81.3

Is T81.3 a billable ICD-10-CM code?: No. T81.3 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does T81.3 sit in the tabular list?: Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Complications of surgical and medical care, not elsewhere classified (T80-T88).
What cannot be coded together with T81.3?: T81.3 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.