T85.41 — Breakdown (mechanical) of breast prosthesis and implant
T85.41 is a non-billable header ICD-10-CM code for breakdown (mechanical) of breast prosthesis and implant. 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
Risk adjustment
T85.41 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.
How T85.41 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to T85.41.
- Breakdown›device, graft or implant›breast(implant)
- Complication›breast implant›mechanical›breakdown
Code to one of these instead T85.41
3 child codes. Green means billable.
Related codes at this level
Codes that share T85.4. If T85.41 is not quite right, the correct code is usually one of these.
Questions about T85.41
- Is T85.41 a billable ICD-10-CM code?
- No. T85.41 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does T85.41 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).