T85.612S
T85.612S: Breakdown (mechanical) of permanent sutures, sequela
Billable / specific codeICD-10-CMPOA exempt
T85.612S is a billable, specific ICD-10-CM code for breakdown (mechanical) of permanent sutures, sequela. It is valid for submission on a claim.
Check T85.612S with the rest of the claim: free scrubber7th 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.
Excludes1 inherited from the categories above T85.612S
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above T85.612S
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
T85.612S is named in 5 Medicare coverage policies: 5 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A53057Billing and Coding: Home Health Occupational Therapy
- A53058Billing and Coding: Home Health Physical Therapy
- A53064Billing and Coding: Outpatient Occupational Therapy
- A57204Billing and Coding: MRI and CT Scans of the Head and Neck
Code history
Unchanged in every release from FY2024 to FY2027.