T85.614A

T85.614A: Breakdown (mechanical) of insulin pump, initial encounter

Billable / specific codeICD-10-CM

T85.614A is a billable, specific ICD-10-CM code for breakdown (mechanical) of insulin pump, initial encounter. It is valid for submission on a claim.

Check T85.614A with the rest of the claim: free scrubber

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 T85.614A

Not part of this code, but both may be coded when both are present.

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

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

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

T85.614A is named in 1 Medicare coverage policy: 1 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A57206Billing and Coding: Lumbar MRI

Code history

Unchanged in every release from FY2024 to FY2027.