2024 ICD-10-CM Diagnosis Code T85.113D

Breakdown (mechanical) of implanted electronic neurostimulator, generator, subsequent encounter

ICD-10-CM Code:
T85.113D
ICD-10 Code for:
Breakdown (mechanical) of implnt elec nstim, generator, subs
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)

T85.113D is a billable diagnosis code used to specify a medical diagnosis of breakdown (mechanical) of implanted electronic neurostimulator, generator, subsequent encounter. 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.

T85.113D is a subsequent encounter code, includes a 7th character and should be used after the patient has completed active treatment for a condition like breakdown (mechanical) of implanted electronic neurostimulator generator. According to ICD-10-CM Guidelines a "subsequent encounter" occurs when the patient is receiving routine care for the condition during the healing or recovery phase of treatment. Subsequent diagnosis codes are appropriate during the recovery phase, no matter how many times the patient has seen the provider for this condition. If the provider needs to adjust the patient's care plan due to a setback or other complication, the encounter becomes active again.

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)

T85.113D 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

T85113D replaces the following previously assigned ICD-10-CM code(s):

  • T85.110D - Breakdown of implnt elec nstim of brain lead, subs
  • T85.110D - Brkdwn implanted electronic neurostim of brain, subs
  • T85.111D - Breakdown of implnt elec nstim of prph nrv lead, subs
  • T85.111D - Brkdwn implanted electronic neurostim of periph nrv, subs
  • T85.112D - Breakdown of implnt elec nstim of spinal cord lead, subs
  • T85.112D - Brkdwn implanted electronic neurostim of spinal cord, subs
  • T85.118D - Brkdwn implanted electronic stimulator of nervous sys, subs

Convert T85.113D to ICD-9-CM

  • ICD-9-CM Code: V58.89 - Other specfied aftercare
    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