2027 ICD-10-CM Diagnosis Code T81.83XAPersistent postprocedural fistula, initial encounter

ICD-10-CM Codes›S00–T88›T80-T88›T81

ICD-10-CM T81.83XA
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

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 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 791, 793, 919 through 921. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 49 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Complication of other surgical or medical care, injury, initial encounter.

Code Identity

ICD-10-CM Code
T81.83XA
Billable Status
Yes — Valid for Submission
Code Describes
Persistent postprocedural fistula, initial encounter
Short Description
Persistent postprocedural fistula, initial encounter
Same as the full description in the CMS dataset.
Parent Code
T81.83
Persistent postprocedural fistula

Code Classification

ChapterS00–T88Injury, poisoning and certain other consequences of external causes
SectionT80-T88Complications of surgical and medical care, not elsewhere classified
CategoryT81Complications of procedures, not elsewhere classified
This CodeT81.83XAPersistent postprocedural fistula, initial encounter

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Acquired abnormality of atrium
  • Acquired fistula of esophagus
  • Atrioesophageal fistula due to radiofrequency ablation
  • Disorder of left atrium as complication of procedure
  • Gastrointestinal fistula following surgical procedure
  • Persistent postoperative fistula
  • Postoperative fistula
  • Postoperative fistula of ureter
  • Postoperative urinary bladder fistula
  • Stomal 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 2027, published by CMS and the National Center for Health Statistics.

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to T81.83XA: its own notes plus those printed at T81.83, T81.8, T81, block T80-T88, and Chapter 19. A note printed at a category, block or chapter applies to every code under it.

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From T81.8 Other complications of procedures, not elsewhere classified applies to 12 codes
  • hypothermia following anesthesia (T88.51)
  • malignant hyperpyrexia due to anesthesia (T88.3)
From T81 Complications of procedures, not elsewhere classified applies to 240 codes
From Block T80-T88 Complications of surgical and medical care, not elsewhere classified applies to 1,683 codes
  • any encounters with medical care for postprocedural conditions in which no complications are present, such as:
  • artificial opening status (Z93.-)
  • closure of external stoma (Z43.-)
  • fitting and adjustment of external prosthetic device (Z44.-)
  • burns and corrosions from local applications and irradiation (T20-T32)
  • complications of surgical procedures during pregnancy, childbirth and the puerperium (O00-O9A)
  • mechanical complication of respirator [ventilator] (J95.850)
  • poisoning and toxic effects of drugs and chemicals (T36-T65 with fifth or sixth character 1-4 or 6)
  • postprocedural fever (R50.82)
  • specified complications classified elsewhere, such as:
  • cerebrospinal fluid leak from spinal puncture (G97.0)
  • colostomy malfunction (K94.0-)
  • disorders of fluid and electrolyte imbalance (E86-E87)
  • functional disturbances following cardiac surgery (I97.0-I97.1)
  • intraoperative and postprocedural complications of specified body systems (D78.-, E36.-, E89.-, G97.3-, G97.4, H59.3-, H59.-, H95.2-, H95.3, I97.4-, I97.5, J95.6-, J95.7, K91.6-, L76.-, M96.-, N99.-)
  • ostomy complications (J95.0-, K94.-, N99.5-)
  • postgastric surgery syndromes (K91.1)
  • postlaminectomy syndrome NEC (M96.1)
  • postmastectomy lymphedema syndrome (I97.2)
  • postsurgical blind-loop syndrome (K91.2)
  • ventilator associated pneumonia (J95.851)
From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes

Use Additional Code

Add a second code, after this one, to fully describe the condition.

From T81.83 Persistent postprocedural fistula applies to 3 codes
  • code, if known, for site of fistula such as:
  • anal fistula (K60.3-)
  • anorectal fistula (K60.5-)
  • bladder fistula (N32.2)
  • other female intestinal-genital tract fistulae (N82.4)
From T81 Complications of procedures, not elsewhere classified applies to 240 codes
  • code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)
From Block T80-T88 Complications of surgical and medical care, not elsewhere classified applies to 1,683 codes
  • code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)
  • code(s) to identify the specified condition resulting from the complication
  • code to identify devices involved and details of circumstances (Y62-Y82)
From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes
  • code to identify any retained foreign body, if applicable (Z18.-)

Code Also

A second code may be needed to fully describe the condition; the note gives no sequencing direction.

From T81.83 Persistent postprocedural fistula applies to 3 codes
  • if applicable, disruption of internal operation (surgical) wound (T81.32-)

Notes

General instructions on how these codes are used.

From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes
  • Use secondary code(s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code
  • The chapter uses the S-section for coding different types of injuries related to single body regions and the T-section to cover injuries to unspecified body regions as well as poisoning and certain other consequences of external causes.

7th Character

Every code in the category takes a 7th character from the listed values, with the placeholder X filling any empty positions before it.

From T81 Complications of procedures, not elsewhere classified applies to 240 codes
  • The appropriate 7th character is to be added to each code from category T81
Values for category T81 Encounter: Initial, Subsequent, Sequela
  • Ainitial encounter this code
  • Dsubsequent encounter
  • Ssequela

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name T81.83XA, its category, or a range that includes it.

Excludes2 1

These codes carry an Excludes2 note naming T81.83XA: its condition is not part of those codes, and both may be reported when the patient has both.

  • T88 Other complications of surgical and medical care, not elsewhere classified
    complication following procedure NEC (T81.-) names T81.-, which includes this code

Code First 1

These codes say to code first a condition named in the note, and T81.83XA is one of the conditions named.

  • J98.51 Mediastinitis
    underlying condition, if applicable, such as postoperative mediastinitis (T81.-) names T81.-, which includes this code

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR INJ037
Complication of other surgical or medical care, injury, initial encounter
Default principal diagnosis: inpatient Yes · outpatient Yes

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.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert T81.83XA to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
998.6 Persist postop fistula
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About T81.83XAOverview

What is the ICD-10 code for persistent postprocedural fistula, initial encounter?

The ICD-10-CM code for persistent postprocedural fistula, initial encounter is T81.83XA (sometimes written as T8183XA). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

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, 2026 through September 30, 2027.

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 793, 791, 920, 919, 921, with relative weights from 0.6719 to 4.2192 depending on complications. Higher weights mean higher Medicare reimbursement.

Is T81.83XA a CC or MCC?

CMS lists T81.83XA as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 49 closely related codes in its exclusion list.