T85.42XA

T85.42XA: Displacement of breast prosthesis and implant, initial encounter

Billable / specific codeICD-10-CM

T85.42XA is a billable, specific ICD-10-CM code for displacement of breast prosthesis and implant, initial encounter. It is valid for submission on a claim.

Check T85.42XA 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.

Malposition of breast prosthesis and implant

Excludes2 inherited from the categories above T85.42XA

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

T85.42XA is named in 8 Medicare coverage policies: 8 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A52849Billing and Coding: Breast Imaging: Breast Echography (Sonography)/Breast MRI/Ductography
A56448Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
A56587Billing and Coding: Cosmetic and Reconstructive Surgery
A56658Billing and Coding: Cosmetic and Reconstructive Surgery

Code history

Unchanged in every release from FY2024 to FY2027.