T81.83XS — Persistent postprocedural fistula, sequela
T81.83XS is a billable, specific ICD-10-CM code for persistent postprocedural fistula, sequela. It is valid for submission on a claim.
7th character "S" — sequela
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 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-)
Risk adjustment
T81.83XS 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
T81.83XS is named in 6 Medicare coverage policies — 6 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A53057Billing and Coding: Home Health Occupational Therapy
- A53058Billing and Coding: Home Health Physical Therapy
- A53064Billing and Coding: Outpatient Occupational Therapy
- A56421Billing and Coding: CT of the Abdomen and Pelvis
Related codes at this level
Codes that share T81.83. If T81.83XS is not quite right, the correct code is usually one of these.
Questions about T81.83XS
- Is T81.83XS a billable ICD-10-CM code?
- Yes. T81.83XS is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T81.83XS 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).