T81.89XA: Other complications of procedures, not elsewhere classified, initial encounter
T81.89XA is a billable, specific ICD-10-CM code for other complications of procedures, not elsewhere classified, initial encounter. It is valid for submission on a claim.
Check T81.89XA with the rest of the claim: free scrubber7th 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 to specify complication, such as:
- postprocedural delirium (F05)
Excludes2 inherited from the categories above T81.89XA
Not part of this code, but both may be coded when both are present.
Written on T81.8: Other complications of procedures, not elsewhere classified
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
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
T81.89XA is named in 7 Medicare coverage policies: 5 listing it as supporting medical necessity, and 2 listing it as NOT covered. Which one applies depends on your Medicare contractor.
- A56566Billing and Coding: Outpatient Physical and Occupational Therapy Servicesnot covered
- A57067Billing and Coding: Outpatient Physical and Occupational Therapy Servicesnot covered
- A55909Billing and Coding: Wound Care
- A56459Billing and Coding: Debridement Services
Code history
Unchanged in every release from FY2024 to FY2027.