T84.018A — Broken internal joint prosthesis, other site, initial encounter
T84.018A is a billable, specific ICD-10-CM code for broken internal joint prosthesis, other site, 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
Use additional code
Add a secondary code to capture the detail described below.
- code to identify the joint (Z96.6-)
Risk adjustment
T84.018A 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
T84.018A is named in 2 Medicare coverage policies — 2 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A57206Billing and Coding: Lumbar MRI
- A57311Billing and Coding: Physical Therapy - Home Health
Related codes at this level
Codes that share T84.018. If T84.018A is not quite right, the correct code is usually one of these.
Questions about T84.018A
- Is T84.018A a billable ICD-10-CM code?
- Yes. T84.018A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T84.018A 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).