2026 ICD-10-CM Diagnosis Code T82.01XABreakdown (mechanical) of heart valve prosthesis, initial encounter

ICD-10-CM Codes›S00–T88›T80-T88›T82

ICD-10-CM T82.01XA
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

T82.01XA is a billable ICD-10-CM diagnosis code for breakdown (mechanical) of heart valve prosthesis, 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 306 through 307. Coders also document this condition as breakage of prosthesis. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Complication of cardiovascular device, implant or graft, initial encounter.

Code Identity

ICD-10-CM Code
T82.01XA
Billable Status
Yes — Valid for Submission
Code Describes
Breakdown (mechanical) of heart valve prosthesis, initial encounter
Short Description
Breakdown (mechanical) of heart valve prosthesis, init
Parent Code
T82.01
Breakdown (mechanical) of heart valve prosthesis

Code Classification

ChapterS00–T88Injury, poisoning and certain other consequences of external causes
SectionT80-T88Complications of surgical and medical care, not elsewhere classified
CategoryT82Complications of cardiac and vascular prosthetic devices, implants and grafts
This CodeT82.01XABreakdown (mechanical) of heart valve prosthesis, initial encounter

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Breakage of prosthesis
  • Failure of cardiac valve prosthesis
  • Prosthetic cardiac valve dehiscence
  • Prosthetic cardiac valve displacement

Coding GuidelinesGuidance

The appropriate 7th character is to be added to each code from block Complications of cardiac and vascular prosthetic devices, implants and grafts (T82). 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.

CCSR INJ033
Complication of cardiovascular device, implant or graft, initial encounter
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Heart Valve Diseases

Heart valve disease happens when one or more of your heart valves don't work well.

The full article covers:

  • What are heart valve diseases?
  • What are the types of heart valve diseases?
  • What causes heart valve diseases?
  • Who is more likely to develop heart valve diseases?
  • What are the symptoms of heart valve diseases?
  • What other problems can heart valve diseases cause?
  • How is heart valve disease diagnosed?
  • What are the treatments for heart valve diseases?

Read the full article at MedlinePlus

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

Convert T82.01XA to ICD-9-CMHistory

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

ICD-9-CM
996.02 Malfunc prosth hrt valve
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 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About T82.01XAOverview

Is T82.01XA (Breakdown (mechanical) of heart valve prosthesis) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report breakdown (mechanical) of heart valve prosthesis, initial encounter on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What does the 7th character A in T82.01XA mean?

The final character A marks the initial encounter: use it while the patient is receiving active treatment for breakdown (mechanical) of heart valve prosthesis, such as an emergency visit or first evaluation.

What MS-DRG does T82.01XA group to?

When breakdown (mechanical) of heart valve prosthesis, initial encounter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 306, 307, with relative weights from 0.9132 to 1.5758 depending on complications. Higher weights mean higher Medicare reimbursement.

What is the ICD-9 equivalent of T82.01XA?

Under the General Equivalence Mappings, breakdown (mechanical) of heart valve prosthesis, initial encounter converts to ICD-9-CM 996.02 (malfunc prosth hrt valve). The mapping is approximate, so confirm the match fits the documentation.