T84.013S
T84.013S — Broken internal left knee prosthesis, sequela
Billable / specific codeICD-10-CMPOA exemptleft
T84.013S is a billable, specific ICD-10-CM code for broken internal left knee prosthesis, 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 T84
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment
T84.013S 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
T84.013S is named in 15 Medicare coverage policies — 15 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
- A53057Billing and Coding: Home Health Occupational Therapy
- A53058Billing and Coding: Home Health Physical Therapy
Related codes at this level
Codes that share T84.013. If T84.013S is not quite right, the correct code is usually one of these.
Questions about T84.013S
- Is T84.013S a billable ICD-10-CM code?
- Yes. T84.013S is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T84.013S 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).