T85.111A

T85.111A: Breakdown (mechanical) of implanted electronic neurostimulator of peripheral nerve electrode (lead), initial encounter

Billable / specific codeICD-10-CM

T85.111A is a billable, specific ICD-10-CM code for breakdown (mechanical) of implanted electronic neurostimulator of peripheral nerve electrode (lead), initial encounter. It is valid for submission on a claim.

Check T85.111A with the rest of the claim: free scrubber

7th character "A": initial encounter

The appropriate 7th character is to be added to each code from category T85

A: initial encounter
D: subsequent encounter
S: sequela

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Breakdown of electrode (lead) for cranial nerve neurostimulators
Breakdown of electrode (lead) for gastric neurostimulator
Breakdown of electrode (lead) for sacral nerve neurostimulator
Breakdown of electrode (lead) for vagal nerve neurostimulators

Excludes2 inherited from the categories above T85.111A

Not part of this code, but both may be coded when both are present.

Written on T85: Complications of other internal prosthetic devices, implants and grafts

failure and rejection of transplanted organs and tissue (T86.-)

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

T85.111A is named in 4 Medicare coverage policies: 4 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A53359Billing and Coding: Sacral Nerve Stimulation for Urinary and Fecal Incontinence
A56747Billing and Coding: Magnetic Resonance Angiography (MRA)
A57204Billing and Coding: MRI and CT Scans of the Head and Neck
A59332Billing and Coding: Sacral Nerve Stimulation for the Treatment of Urinary and Fecal Incontinence

Code history

Unchanged in every release from FY2024 to FY2027.