Is T85.612 a billable ICD-10-CM code?

No. T85.612 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does T85.612 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 T85.612?

T85.612 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

T85.612

T85.612 — Breakdown (mechanical) of permanent sutures

Non-billable headerICD-10-CM

T85.612 is a non-billable header ICD-10-CM code for breakdown (mechanical) of permanent sutures. 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

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

mechanical complication of permanent (wire) suture used in bone repair (T84.1-T84.2)

Other codes that can never be billed with T85.612

These codes carry an Excludes1 note pointing at T85.612. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading T85.612 alone.

T81.3Disruption of wound, not elsewhere classified

Risk adjustment

T85.612 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 T85.612 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 T85.612.

Breakdown›device, graft or implant›sutures, permanent
Complication›suture, permanent NEC›mechanical›breakdown
Complication›suture, permanent NEC›mechanical›malfunction

Code to one of these instead T85.612

3 child codes. Green means billable.

Related codes at this level

Codes that share T85.61. If T85.612 is not quite right, the correct code is usually one of these.

Questions about T85.612

Is T85.612 a billable ICD-10-CM code?: No. T85.612 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does T85.612 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 T85.612?: T85.612 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.