2024 ICD-10-CM Diagnosis Code T85.818S

Embolism due to other internal prosthetic devices, implants and grafts, sequela

ICD-10-CM Code:
T85.818S
ICD-10 Code for:
Embolism due to other internal prosth dev/grft, sequela
Is Billable?
Yes - 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)

T85.818S is a billable diagnosis code used to specify a medical diagnosis of embolism due to other internal prosthetic devices, implants and grafts, sequela. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

T85.818S is a sequela code, includes a 7th character and should be used for complications that arise as a direct result of a condition like embolism due to other internal prosthetic devices implants and grafts. According to ICD-10-CM Guidelines a "sequela" code should be used for chronic or residual conditions that are complications of an initial acute disease, illness or injury. The most common sequela is pain. Usually, two diagnosis codes are needed when reporting sequela. The first code describes the nature of the sequela while the second code describes the sequela or late effect.

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • Embolism due to any device, implant AND/OR graft
  • Internal prosthetic device causing embolism

Clinical Classification

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

Present on Admission (POA)

T85.818S is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here.

CMS POA Indicator Options and Definitions

POA IndicatorReason for CodeCMS will pay the CC/MCC DRG?
YDiagnosis was present at time of inpatient admission.YES
NDiagnosis was not present at time of inpatient admission.NO
UDocumentation insufficient to determine if the condition was present at the time of inpatient admission.NO
WClinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.YES
1Unreported/Not used - Exempt from POA reporting. NO

Replacement Code

T85818S replaces the following previously assigned ICD-10-CM code(s):

  • T85.81XS - Embolism due to internal prosth dev/grft, NEC, sequela

Convert T85.818S to ICD-9-CM

  • ICD-9-CM Code: 909.3 - Late eff surg/med compl
    Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

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