T81.536D — Perforation due to foreign body accidentally left in body following aspiration, puncture or other catheterization, subsequent encounter
T81.536D is a billable, specific ICD-10-CM code for perforation due to foreign body accidentally left in body following aspiration, puncture or other catheterization, subsequent encounter. It is valid for submission on a claim.
7th character "D" — subsequent encounter
The appropriate 7th character is to be added to each code from category T81
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Excludes2 inherited from the categories above T81.536D
Also inherited, and the opposite of Excludes1: these conditions are not part of T81.536D, but a patient can have both, so you may code both.
Written on T81 — Complications of procedures, not elsewhere classified
- complications following immunization (T88.0-T88.1)
- complications following infusion, transfusion and therapeutic injection (T80.-)
- complications of transplanted organs and tissue (T86.-)
- specified complications classified elsewhere, such as:
- complication of prosthetic devices, implants and grafts (T82-T85)
- dermatitis due to drugs and medicaments (L23.3, L24.4, L25.1, L27.0-L27.1)
- endosseous dental implant failure (M27.6-)
- floppy iris syndrome (IFIS) (intraoperative) H21.81
- intraoperative and postprocedural complications of specific body system (D78.-, E36.-, E89.-, G97.3-, G97.4, H59.3-, H59.-, H95.2-, H95.3, I97.4-, I97.5, J95, K91.-, L76.-, M96.-, N99.-)
- ostomy complications (J95.0-, K94.-, N99.5-)
- plateau iris syndrome (post-iridectomy) (postprocedural) H21.82
- poisoning and toxic effects of drugs and chemicals (T36-T65 with fifth or sixth character 1-4)
Risk adjustment
T81.536D 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.
Medicare coverage
T81.536D is named in 5 Medicare coverage policies — 5 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A53058Billing and Coding: Home Health Physical Therapy
- A56421Billing and Coding: CT of the Abdomen and Pelvis
- A56612Billing and Coding: CT of the Head
- A57204Billing and Coding: MRI and CT Scans of the Head and Neck
Code history
T81.536D has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share T81.536. If T81.536D is not quite right, the correct code is usually one of these.
Questions about T81.536D
- Is T81.536D a billable ICD-10-CM code?
- Yes. T81.536D is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T81.536D 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).