T85.858A — Stenosis due to other internal prosthetic devices, implants and grafts, initial encounter
T85.858A is a billable, specific ICD-10-CM code for stenosis due to other internal prosthetic devices, implants and grafts, 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
T85.858A 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
T85.858A is named in 4 Medicare coverage policies — 4 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
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- A59299Billing and Coding: Cosmetic and Reconstructive Surgery
Related codes at this level
Codes that share T85.858. If T85.858A is not quite right, the correct code is usually one of these.
Questions about T85.858A
- Is T85.858A a billable ICD-10-CM code?
- Yes. T85.858A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T85.858A 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).