Version 2024

2024 ICD-10-CM Diagnosis Code T85.4

Mechanical complication of breast prosthesis and implant

ICD-10-CM Code:
T85.4
ICD-10 Code for:
Mechanical complication of breast prosthesis and implant
Is Billable?
Not Valid for Submission
Code Navigator:

Code Classification

  • Injury, poisoning and certain other consequences of external causes
    (S00–T88)
    • Complications of surgical and medical care, not elsewhere classified
      (T80-T88)
      • Complications of other internal prosthetic devices, implants and grafts
        (T85)

T85.4 is a non-specific and non-billable diagnosis code code, consider using a code with a higher level of specificity for a diagnosis of mechanical complication of breast prosthesis and implant. The code is not specific and is NOT valid for the year 2024 for the submission of HIPAA-covered transactions. Category or Header define the heading of a category of codes that may be further subdivided by the use of 4th, 5th, 6th or 7th characters.

Specific Coding Applicable to Mechanical complication of breast prosthesis and implant

Non-specific codes like T85.4 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10-CM codes with a higher level of specificity when coding for mechanical complication of breast prosthesis and implant:

  • T85.41 for Breakdown (mechanical) of breast prosthesis and implant - NON-BILLABLE CODE

  • Use T85.41XA for initial encounter - BILLABLE CODE

  • Use T85.41XD for subsequent encounter - BILLABLE CODE

  • Use T85.41XS for sequela - BILLABLE CODE

  • T85.42 for Displacement of breast prosthesis and implant - NON-BILLABLE CODE

  • Use T85.42XA for initial encounter - BILLABLE CODE

  • Use T85.42XD for subsequent encounter - BILLABLE CODE

  • Use T85.42XS for sequela - BILLABLE CODE

  • T85.43 for Leakage of breast prosthesis and implant - NON-BILLABLE CODE

  • Use T85.43XA for initial encounter - BILLABLE CODE

  • Use T85.43XD for subsequent encounter - BILLABLE CODE

  • Use T85.43XS for sequela - BILLABLE CODE

  • T85.44 for Capsular contracture of breast implant - NON-BILLABLE CODE

  • Use T85.44XA for initial encounter - BILLABLE CODE

  • Use T85.44XD for subsequent encounter - BILLABLE CODE

  • Use T85.44XS for sequela - BILLABLE CODE

  • T85.49 for Other mechanical complication of breast prosthesis and implant - NON-BILLABLE CODE

  • Use T85.49XA for initial encounter - BILLABLE CODE

  • Use T85.49XD for subsequent encounter - BILLABLE CODE

  • Use T85.49XS for sequela - BILLABLE CODE

Coding Guidelines

The appropriate 7th character is to be added to each code from block Complications of other internal prosthetic devices, implants and grafts (T85). Use the following options for the aplicable episode of care:

  • A - initial encounter
  • D - subsequent encounter
  • S - sequela

Patient Education


Breast Reconstruction

If you need a mastectomy, you have a choice about whether or not to have surgery to rebuild the shape of the breast. Instead of breast reconstruction, you could choose to wear a breast form that replaces the breast, wear padding inside your bra, or do nothing. All of these options have pros and cons. What is right for one woman may not be right for another.

Breast reconstruction may be done at the same time as the mastectomy, or it may be done later on. If radiation therapy is part of the treatment plan, your doctor may suggest waiting until after radiation therapy.

If you're thinking about breast reconstruction, talk to a plastic surgeon before the mastectomy, even if you plan to have your reconstruction later on.

A surgeon can reconstruct the breast in many ways. Some women choose to have breast implants, which are filled with saline or silicone gel. Another method uses tissue taken from another part of your body. The plastic surgeon can take skin, muscle, and fat from your lower abdomen, back, or buttocks.

The type of reconstruction that is best for you depends on your age, body type, and the type of cancer surgery that you had. A plastic surgeon can help you decide.

NIH: National Cancer Institute


[Learn More in MedlinePlus]

Code History

  • FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
  • FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
  • FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.