2026 ICD-10-CM Diagnosis Code T81.83XAPersistent postprocedural fistula, initial encounter
T81.83XA is a billable ICD-10-CM diagnosis code for persistent postprocedural fistula, initial encounter. The 7th character A marks it as an initial encounter code, used while the patient is receiving active treatment. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 919 through 921. Coders also document this condition as external stoma fistula. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Complication of other surgical or medical care, injury, initial encounter.
Code Identity
Code Classification
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- External stoma fistula
- Internal stoma fistula
- Persistent postoperative fistula
- Postoperative fistula
- Postoperative fistula of ureter
- Postoperative urinary bladder fistula
- Ureteric fistula
Coding GuidelinesGuidance
The appropriate 7th character is to be added to each code from block Complications of procedures, not elsewhere classified (T81). Use the following options for the applicable episode of care:
- A - initial encounter
- D - subsequent encounter
- S - sequela
Source: ICD-10-CM Official Guidelines for Coding and Reporting, FY 2026, published by CMS and the National Center for Health Statistics.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Ureteric Fistula
an abnormal communication between the ureter and another organ or anatomic site.
Patient EducationClinical
Fistulas
A fistula is an abnormal connection between two parts inside of the body. Fistulas may develop between different organs, such as between the esophagus and the windpipe or the bowel and the vagina. They can also develop between two blood vessels, such as between an artery and a vein or between two arteries.
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Convert T81.83XA to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About T81.83XAOverview
Is T81.83XA (Persistent postprocedural fistula) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report persistent postprocedural fistula, initial encounter on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character A in T81.83XA mean?
The final character A marks the initial encounter: use it while the patient is receiving active treatment for persistent postprocedural fistula, such as an emergency visit or first evaluation.
What MS-DRG does T81.83XA group to?
When persistent postprocedural fistula, initial encounter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 919, 920, 921, with relative weights from 0.6884 to 1.8308 depending on complications. Higher weights mean higher Medicare reimbursement.
What is the ICD-9 equivalent of T81.83XA?
Under the General Equivalence Mappings, persistent postprocedural fistula, initial encounter converts to ICD-9-CM 998.6 (persist postop fistula). The mapping is approximate, so confirm the match fits the documentation.
Footnotes
[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.
