T84.85XA
T84.85XA: Stenosis due to internal orthopedic prosthetic devices, implants and grafts, initial encounter
Billable / specific codeICD-10-CM
T84.85XA is a billable, specific ICD-10-CM code for stenosis due to internal orthopedic prosthetic devices, implants and grafts, initial encounter. It is valid for submission on a claim.
Check T84.85XA with the rest of the claim: free scrubber7th 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
Excludes2 inherited from the categories above T84.85XA
Not part of this code, but both may be coded when both are present.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
T84.85XA is named in 2 Medicare coverage policies: 2 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52465Knee Orthoses - Policy Article
- A57311Billing and Coding: Physical Therapy - Home Health
Code history
Unchanged in every release from FY2024 to FY2027.