T84.011D
T84.011D — Broken internal left hip prosthesis, subsequent encounter
Billable / specific codeICD-10-CMPOA exemptleft
T84.011D is a billable, specific ICD-10-CM code for broken internal left hip prosthesis, 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 T84
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment
T84.011D 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
T84.011D is named in 11 Medicare coverage policies — 11 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
- A53065Billing and Coding: Outpatient Physical Therapy
- A56777Billing and Coding: Total Joint Arthroplasty
- A56796Billing and Coding: Lower Extremity Major Joint Replacement (Hip and Knee)
Related codes at this level
Codes that share T84.011. If T84.011D is not quite right, the correct code is usually one of these.
Questions about T84.011D
- Is T84.011D a billable ICD-10-CM code?
- Yes. T84.011D is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T84.011D 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).