T84.54XA — Infection and inflammatory reaction due to internal left knee prosthesis, initial encounter
T84.54XA is a billable, specific ICD-10-CM code for infection and inflammatory reaction due to 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
T84.54XA 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
T84.54XA is named in 18 Medicare coverage policies — 18 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
- A52868Billing and Coding: Transesophageal Echocardiography (TEE)
- A56777Billing and Coding: Total Joint Arthroplasty
Related codes at this level
Codes that share T84.54. If T84.54XA is not quite right, the correct code is usually one of these.
Questions about T84.54XA
- Is T84.54XA a billable ICD-10-CM code?
- Yes. T84.54XA is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T84.54XA 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).