T85.111S

T85.111S: Breakdown (mechanical) of implanted electronic neurostimulator of peripheral nerve electrode (lead), sequela

Billable / specific codeICD-10-CMPOA exempt

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

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

7th character "S": sequela

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 T85.111S

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

T85.111S is named in 8 Medicare coverage policies: 8 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A53057Billing and Coding: Home Health Occupational Therapy
A53058Billing and Coding: Home Health Physical Therapy
A53064Billing and Coding: Outpatient Occupational Therapy
A53065Billing and Coding: Outpatient Physical Therapy

Code history

Unchanged in every release from FY2024 to FY2027.