T84.013A
T84.013A — Broken internal left knee prosthesis, initial encounter
Billable / specific codeICD-10-CMleft
T84.013A is a billable, specific ICD-10-CM code for broken internal left knee prosthesis, 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 T84
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment
T84.013A 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
T84.013A 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.
- A52465Knee Orthoses - Policy Article
- A52465Knee Orthoses - Policy Article
- 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 T84.013. If T84.013A is not quite right, the correct code is usually one of these.
Questions about T84.013A
- Is T84.013A a billable ICD-10-CM code?
- Yes. T84.013A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T84.013A 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).