T88.1XXS: Other complications following immunization, not elsewhere classified, sequela
T88.1XXS is a billable, specific ICD-10-CM code for other complications following immunization, not elsewhere classified, sequela. It is valid for submission on a claim.
Check T88.1XXS with the rest of the claim: free scrubber7th character "S": sequela
The appropriate 7th character is to be added to each code from category T88
- 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.
- vaccinia not from vaccine (B08.011)
Excludes2: not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Generalized vaccinia
- Rash following immunization
Excludes1 inherited from the categories above T88.1XXS
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above T88.1XXS
Not part of this code, but both may be coded when both are present.
Written on T88.1: Other complications following immunization, not elsewhere classified
Written on T88: Other complications of surgical and medical care, not elsewhere classified
- complication following infusion, transfusion and therapeutic injection (T80.-)
- complication following procedure NEC (T81.-)
- complications of anesthesia in labor and delivery (O74.-)
- complications of anesthesia in pregnancy (O29.-)
- complications of anesthesia in puerperium (O89.-)
- complications of devices, implants and grafts (T82-T85)
- complications of obstetric surgery and procedure (O75.4)
- dermatitis due to drugs and medicaments (L23.3, L24.4, L25.1, L27.0-L27.1)
- poisoning and toxic effects of drugs and chemicals (T36-T65 with fifth or sixth character 1-4)
- specified complications classified elsewhere
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
T88.1XXS is named in 4 Medicare coverage policies: 4 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
- A53065Billing and Coding: Outpatient Physical Therapy
- A57206Billing and Coding: Lumbar MRI
Code history
Unchanged in every release from FY2024 to FY2027.