T85.111D — Breakdown (mechanical) of implanted electronic neurostimulator of peripheral nerve electrode (lead), subsequent encounter
T85.111D is a billable, specific ICD-10-CM code for breakdown (mechanical) of implanted electronic neurostimulator of peripheral nerve electrode (lead), subsequent encounter. It is valid for submission on a claim.
7th character "D" — subsequent 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
Risk adjustment
T85.111D 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
T85.111D is named in 6 Medicare coverage policies — 6 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A53058Billing and Coding: Home Health Physical Therapy
- A53065Billing and Coding: Outpatient Physical Therapy
- A53359Billing and Coding: Sacral Nerve Stimulation for Urinary and Fecal Incontinence
- A56747Billing and Coding: Magnetic Resonance Angiography (MRA)
Related codes at this level
Codes that share T85.111. If T85.111D is not quite right, the correct code is usually one of these.
Questions about T85.111D
- Is T85.111D a billable ICD-10-CM code?
- Yes. T85.111D is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T85.111D 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).