T85 — Complications of other internal prosthetic devices, implants and grafts
T85 is a non-billable header ICD-10-CM code for complications of other internal prosthetic devices, implants and grafts. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.
This code requires a 7th character
The appropriate 7th character is to be added to each code from category T85
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Excludes2 — not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
- failure and rejection of transplanted organs and tissue (T86.-)
Other codes that can never be billed with T85
These codes carry an Excludes1 note pointing at T85. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading T85 alone.
- Z44.2Encounter for fitting and adjustment of artificial eye
- H27Other disorders of lens
- H59Intraoperative and postprocedural complications and disorders of eye and adnexa, not elsewhere classified
- T81.3Disruption of wound, not elsewhere classified
- T82.4Mechanical complication of vascular dialysis catheter
- Z44.3Encounter for fitting and adjustment of external breast prosthesis
- Z45.81Encounter for adjustment or removal of breast implant
- Z97Presence of other devices
Risk adjustment
T85 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.
Code to one of these instead T85
10 child codes. Green means billable.
- T85.0Mechanical complication of ventricular intracranial (communicating) shunt
- T85.1Mechanical complication of implanted electronic stimulator of nervous system
- T85.2Mechanical complication of intraocular lens
- T85.3Mechanical complication of other ocular prosthetic devices, implants and grafts
- T85.4Mechanical complication of breast prosthesis and implant
- T85.5Mechanical complication of gastrointestinal prosthetic devices, implants and grafts
- T85.6Mechanical complication of other specified internal and external prosthetic devices, implants and grafts
- T85.7Infection and inflammatory reaction due to other internal prosthetic devices, implants and grafts
- T85.8Other specified complications of internal prosthetic devices, implants and grafts, not elsewhere classified
- T85.9Unspecified complication of internal prosthetic device, implant and graft
Questions about T85
- Is T85 a billable ICD-10-CM code?
- No. T85 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does T85 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).