T85.113A — Breakdown (mechanical) of implanted electronic neurostimulator, generator, initial encounter
T85.113A is a billable, specific ICD-10-CM code for breakdown (mechanical) of implanted electronic neurostimulator, generator, initial encounter. It is valid for submission on a claim.
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 (mechanical) of implanted electronic neurostimulator generator, brain, peripheral, gastric, spinal
- Breakdown (mechanical) of implanted electronic sacral neurostimulator, pulse generator or receiver
Risk adjustment
T85.113A 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
T85.113A is named in 4 Medicare coverage policies — 4 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A53359Billing and Coding: Sacral Nerve Stimulation for Urinary and Fecal Incontinence
- A56747Billing and Coding: Magnetic Resonance Angiography (MRA)
- A57791Billing and Coding: Spinal Cord Stimulators for Chronic Pain
- A59332Billing and Coding: Sacral Nerve Stimulation for the Treatment of Urinary and Fecal Incontinence
Related codes at this level
Codes that share T85.113. If T85.113A is not quite right, the correct code is usually one of these.
Questions about T85.113A
- Is T85.113A a billable ICD-10-CM code?
- Yes. T85.113A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T85.113A 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).