ICD-10 Code T85.9XXD

Unspecified complication of internal prosthetic device, implant and graft, subsequent encounter

Version 2019 Billable Code POA Exempt

Valid for Submission

T85.9XXD is a billable code used to specify a medical diagnosis of unspecified complication of internal prosthetic device, implant and graft, subsequent encounter. The code is valid for the year 2020 for the submission of HIPAA-covered transactions.

ICD-10: T85.9XXD
Short Description:Unsp complication of internal prosth dev/grft, subs
Long Description:Unspecified complication of internal prosthetic device, implant and graft, subsequent encounter

Code Classification

  • Injury, poisoning and certain other consequences of external causes (S00–T98)
    • Complications of surgical and medical care, not elsewhere classified (T80-T88)
      • Complications of internal prosth dev/grft (T85)

Code History

  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
    (first year ICD-10-CM implemented into the HIPAA mandated code set)
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020

Information for Medical Professionals

Diagnostic Related Groups

The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC). The diagnosis code T85.9XXD is grouped in the following groups for version MS-DRG V37.0 applicable from 10/01/2020 through 09/30/2020.

  • 949 - AFTERCARE WITH CC/MCC
  • 950 - AFTERCARE WITHOUT CC/MCC

Convert T85.9XXD to ICD-9

The following crosswalk between ICD-10 to ICD-9 is based based on the General Equivalence Mappings (GEMS) information:

  • V58.89 - Other specfied aftercare (Approximate Flag)

Present on Admission (POA)

T85.9XXD 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.

CMS POA Indicator Options and Definitions
POA Indicator CodePOA Reason 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

Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • Adverse effect of prosthetic device
  • Airway device cuff problem
  • Complication associated with device
  • Complication associated with insulin pump
  • Complication associated with nervous system implant
  • Complication associated with neurological device
  • Complication associated with saline breast implant
  • Complication associated with silicone gel-filled breast implant
  • Complication associated with vagal nerve stimulator
  • Complication of bypass graft
  • Complication of catheter
  • Complication of electronic internal device
  • Complication of internal anastomosis
  • Complication of internal device
  • Complication of internal prosthetic device
  • Complication of intraocular lens implant
  • Complication of peritoneal dialysis
  • Complication of reimplant
  • Disorder of bile duct prosthesis
  • Disorder of bile duct stent
  • Disorder of breast implant
  • Disorder of dorsal column stimulator
  • Disorder of electrodes implanted in brain
  • Disorder of esophageal tubal prosthesis
  • Disorder of gastrointestinal prostheses or implants
  • Disorder of implanted esophageal antireflux device
  • Disorder of intraocular lens
  • Disorder of pancreatic duct anastomosis
  • Disorder of pancreatic stent
  • Disorder of peripheral nerve graft
  • Disorder of peritoneal dialysis catheter
  • Disorder of prostheses and implants
  • Disorders of musculoskeletal implants and repairs
  • Disorders of prostheses and implants of the eye
  • Disorders of prostheses and implants of the nervous system
  • Failed insertion
  • Failed subcutaneous contraceptive insertion
  • Finding of respiratory device
  • Graft complications
  • Mechanical complication of chin prosthesis
  • Mechanical complication of peripheral nerve graft
  • Tissue expander disorder
  • Urinary tract internal anastomosis complication

ICD-10 Footnotes

General Equivalence Map Definitions
The ICD-10 and ICD-9 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.

  • Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
  • No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
  • Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.