T85.611A
T85.611A: Breakdown (mechanical) of intraperitoneal dialysis catheter, initial encounter
Billable / specific codeICD-10-CM
T85.611A is a billable, specific ICD-10-CM code for breakdown (mechanical) of intraperitoneal dialysis catheter, initial encounter. It is valid for submission on a claim.
Check T85.611A with the rest of the claim: free scrubber7th 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
Excludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- mechanical complication of vascular dialysis catheter (T82.4-)
Excludes1 inherited from the categories above T85.611A
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above T85.611A
Not part of this code, but both may be coded when both are present.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
T85.611A is named in 2 Medicare coverage policies: 2 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A56456Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
- A57206Billing and Coding: Lumbar MRI
Code history
Unchanged in every release from FY2024 to FY2027.