Is T85.528A a billable ICD-10-CM code?

Yes. T85.528A is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does T85.528A 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).

T85.528A

T85.528A — Displacement of other gastrointestinal prosthetic devices, implants and grafts, initial encounter

Billable / specific codeICD-10-CM

T85.528A is a billable, specific ICD-10-CM code for displacement of other gastrointestinal prosthetic devices, implants and grafts, 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

Excludes2 inherited from the categories above T85.528A

Also inherited, and the opposite of Excludes1: these conditions are not part of T85.528A, but a patient can have both, so you may code both.

Written on T85 — Complications of other internal prosthetic devices, implants and grafts

failure and rejection of transplanted organs and tissue (T86.-)

Risk adjustment

T85.528A 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

T85.528A is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A56422Billing and Coding: Bariatric Surgical Management of Morbid Obesity

Code history

T85.528A has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share T85.528. If T85.528A is not quite right, the correct code is usually one of these.

Questions about T85.528A

Is T85.528A a billable ICD-10-CM code?: Yes. T85.528A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does T85.528A 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).