T85.611S — Breakdown (mechanical) of intraperitoneal dialysis catheter, sequela
T85.611S is a billable, specific ICD-10-CM code for breakdown (mechanical) of intraperitoneal dialysis catheter, sequela. It is valid for submission on a claim.
7th character "S" — sequela
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-)
Risk adjustment
T85.611S 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
T85.611S is named in 2 Medicare coverage policies — 2 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A53057Billing and Coding: Home Health Occupational Therapy
- A57206Billing and Coding: Lumbar MRI
Related codes at this level
Codes that share T85.611. If T85.611S is not quite right, the correct code is usually one of these.
Questions about T85.611S
- Is T85.611S a billable ICD-10-CM code?
- Yes. T85.611S is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T85.611S 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).
- What cannot be coded together with T85.611S?
- T85.611S carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.