T85.72XA
T85.72XA — Infection and inflammatory reaction due to insulin pump, initial encounter
Billable / specific codeICD-10-CM
T85.72XA is a billable, specific ICD-10-CM code for infection and inflammatory reaction due to insulin pump, initial encounter. It is valid for submission on a claim.
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
Risk adjustment
T85.72XA 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
T85.72XA is named in 6 Medicare coverage policies — 6 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A57070Billing and Coding: Ophthalmic Biometry for Intraocular Lens Power Calculation
- A57206Billing and Coding: Lumbar MRI
- A58710Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
- A58720Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Related codes at this level
Codes that share T85.72. If T85.72XA is not quite right, the correct code is usually one of these.
Questions about T85.72XA
- Is T85.72XA a billable ICD-10-CM code?
- Yes. T85.72XA is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T85.72XA 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).