T84.84XA — Pain due to internal orthopedic prosthetic devices, implants and grafts, initial encounter
T84.84XA is a billable, specific ICD-10-CM code for pain due to internal orthopedic prosthetic devices, implants and grafts, 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
T84.84XA 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
T84.84XA is named in 3 Medicare coverage policies — 3 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
- A57311Billing and Coding: Physical Therapy - Home Health
Related codes at this level
Codes that share T84.84. If T84.84XA is not quite right, the correct code is usually one of these.
Questions about T84.84XA
- Is T84.84XA a billable ICD-10-CM code?
- Yes. T84.84XA is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T84.84XA 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).