Is T81.83XA a billable ICD-10-CM code?

Yes. T81.83XA is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does T81.83XA 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).

T81.83XA

T81.83XA — Persistent postprocedural fistula, initial encounter

Billable / specific codeICD-10-CM

T81.83XA is a billable, specific ICD-10-CM code for persistent postprocedural fistula, initial encounter. It is valid for submission on a claim.

7th character "A" — initial encounter

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

A: initial encounter
D: subsequent encounter
S: sequela

Use additional code

Add a secondary code to capture the detail described below.

code, if known, for site of fistula such as:
anal fistula (K60.3-)
anorectal fistula (K60.5-)
bladder fistula (N32.2)
other female intestinal-genital tract fistulae (N82.4)

Code also

Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.

, if applicable, disruption of internal operation (surgical) wound (T81.32-)

Excludes2 inherited from the categories above T81.83XA

Also inherited, and the opposite of Excludes1: these conditions are not part of T81.83XA, but a patient can have both, so you may code both.

Written on T81.8 — Other complications of procedures, not elsewhere classified

hypothermia following anesthesia (T88.51)
malignant hyperpyrexia due to anesthesia (T88.3)

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

T81.83XA 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

T81.83XA is named in 4 Medicare coverage policies — 4 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A55909Billing and Coding: Wound Care
A56421Billing and Coding: CT of the Abdomen and Pelvis
A57204Billing and Coding: MRI and CT Scans of the Head and Neck
A57206Billing and Coding: Lumbar MRI

Code history

T81.83XA 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 T81.83. If T81.83XA is not quite right, the correct code is usually one of these.

Questions about T81.83XA

Is T81.83XA a billable ICD-10-CM code?: Yes. T81.83XA is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does T81.83XA 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).