2026 ICD-10-CM Diagnosis Code T82.512ABreakdown (mechanical) of artificial heart, initial encounter
ICD-10-CM Codes›S00–T88›T80-T88›T82
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Risk Adjusts — HCC 223
- 7th Character A — Initial Encounter
T82.512A is a billable ICD-10-CM diagnosis code for breakdown (mechanical) of artificial heart, 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 314 through 316. 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 59 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Complication of cardiovascular device, implant or graft, initial encounter.
For Medicare Advantage risk adjustment, T82.512A maps to CMS-HCC Category 223 (Heart Assist Device/Artificial Heart) under the V28 model, adding a risk factor of about 2.505 for a community, non-dual, aged beneficiary in payment year 2026.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
T82.512A maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2026.
Source: CMS Payment Year 2026 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
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.
Convert T82.512A to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About T82.512AOverview
What is the ICD-10 code for breakdown (mechanical) of artificial heart, initial encounter?
The ICD-10-CM code for breakdown (mechanical) of artificial heart, initial encounter is T82.512A (sometimes written as T82512A). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
Is T82.512A (Breakdown (mechanical) of artificial heart) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report breakdown (mechanical) of artificial heart, initial encounter on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character A in T82.512A mean?
The final character A marks the initial encounter: use it while the patient is receiving active treatment for breakdown (mechanical) of artificial heart, such as an emergency visit or first evaluation.
What MS-DRG does T82.512A group to?
When breakdown (mechanical) of artificial heart, initial encounter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 314, 315, 316, with relative weights from 0.6821 to 2.0852 depending on complications. Higher weights mean higher Medicare reimbursement.
Is T82.512A a CC or MCC?
CMS lists T82.512A as a CC (complication or comorbidity) for FY 2026. 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 59 closely related codes in its exclusion list.
What HCC is T82.512A?
T82.512A (breakdown (mechanical) of artificial heart, initial encounter) maps to CMS-HCC Category 223 (Heart Assist Device/Artificial Heart), commonly written as HCC 223, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2026. It does not map to any RxHCC in the Part D prescription drug model.
Does T82.512A risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, T82.512A adds a risk adjustment factor of about 2.505 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.826 to 6.612 depending on the payment segment). A more severe related category (HCC 221 and HCC 222) supersedes it when both are reported. See the full factor table on the HCC 223 category page.
