2027 ICD-10-CM Diagnosis Code T85.611ABreakdown (mechanical) of intraperitoneal dialysis catheter, initial encounter

ICD-10-CM Codes›S00–T88›T80-T88›T85

ICD-10-CM T85.611A
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

T85.611A is a billable ICD-10-CM diagnosis code for breakdown (mechanical) of intraperitoneal dialysis catheter, 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 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 57 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Complication of other surgical or medical care, injury, initial encounter.

T85.611A no longer risk-adjusts for Medicare Advantage: it mapped to HCC 134 under the retired CMS-HCC V24 model through payment year 2025 but maps to no category in the live V28 model. It still risk-adjusts in the PACE (CMS-HCC V22) category 134, ESRD (V21) category 134, ESRD (V24) category 134, and RxHCC Part D (V08) category 261 for payment year 2027.

Code Identity

ICD-10-CM Code
T85.611A
Billable Status
Yes — Valid for Submission
Code Describes
Breakdown (mechanical) of intraperitoneal dialysis catheter, initial encounter
Short Description
Breakdown of intraperitoneal dialysis catheter, init
Parent Code
T85.611
Breakdown (mechanical) of intraperitoneal dialysis catheter

Code Classification

ChapterS00–T88Injury, poisoning and certain other consequences of external causes
SectionT80-T88Complications of surgical and medical care, not elsewhere classified
CategoryT85Complications of other internal prosthetic devices, implants and grafts
This CodeT85.611ABreakdown (mechanical) of intraperitoneal dialysis catheter, initial encounter

Medicare Risk Adjustment (HCC)Billing

T85.611A no longer risk-adjusts for Medicare Advantage: it maps to no payment category in the live CMS-HCC V28 model, although it still risk-adjusts in the other CMS models shown below.

CMS-HCC V28 (Medicare Advantage Payment Model)
Not mapped
Dropped in V28 see all codes that no longer risk-adjust
Prior Model (CMS-HCC V24)
HCC 134
V24 retired last contributed to a Medicare Advantage risk score in payment year 2025
Other CMS Models
PACE (CMS-HCC V22): HCC 134 · ESRD (V21): HCC 134 · ESRD (V24): HCC 134
ESRD V21 weights: 0.000 dialysis, 0.000 functioning graft · ESRD V24 weights: 0.000 dialysis, 0.000 functioning graft
Part D (RxHCC)
RxHCC 261 — Dialysis Status, Including End Stage Renal Disease
also risk-adjusts in the Part D prescription drug model (V08)

Source: CMS Payment Year 2027 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 other internal prosthetic devices, implants and grafts (T85). 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 T85.611A: its own notes plus those printed at T85.611, T85, block T80-T88, and Chapter 19. A note printed at a category, block or chapter applies to every code under it.

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From T85.611 Breakdown (mechanical) of intraperitoneal dialysis catheter applies to 3 codes
  • mechanical complication of vascular dialysis catheter (T82.4-)

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 T85 Complications of other internal prosthetic devices, implants and grafts applies to 288 codes
  • failure and rejection of transplanted organs and tissue (T86.-)
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 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.-)

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 T85 Complications of other internal prosthetic devices, implants and grafts applies to 288 codes
  • The appropriate 7th character is to be added to each code from category T85
Values for category T85 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 T85.611A, its category, or a range that includes it.

Excludes2 1

These codes carry an Excludes2 note naming T85.611A: its condition is not part of those codes, and both may be reported when the patient has both.

  • T82.5 Mechanical complication of other cardiac and vascular devices and implants
    mechanical complication of epidural and subdural infusion catheter (T85.61) names T85.61, 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

Dialysis

When your kidneys are healthy, they clean your blood. They also make hormones that keep your bones strong and your blood healthy. When your kidneys fail, you need treatment to replace the work your kidneys used to do. Unless you have a kidney transplant, you will need a treatment called dialysis.

Read the full article at MedlinePlus

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

Convert T85.611A to ICD-9-CMHistory

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

ICD-9-CM
996.56 Comp-periton dialys cath
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 T85.611AOverview

Is T85.611A (Breakdown (mechanical) of intraperitoneal dialysis catheter) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report breakdown (mechanical) of intraperitoneal dialysis catheter, initial encounter on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What does the 7th character A in T85.611A mean?

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

What MS-DRG does T85.611A group to?

When breakdown (mechanical) of intraperitoneal dialysis catheter, initial encounter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 920, 919, 921, with relative weights from 0.6719 to 1.7624 depending on complications. Higher weights mean higher Medicare reimbursement.

Is T85.611A a CC or MCC?

CMS lists T85.611A 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 57 closely related codes in its exclusion list.

Can T85.611A be reported with a code from T82.4?

Not as a rule. The Excludes1 note at T85.611, which applies to T85.611A, lists "mechanical complication of vascular dialysis catheter (T82.4-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).

Does T85.611A risk-adjust for Medicare Advantage payment?

Not for Medicare Advantage. T85.611A mapped to HCC 134 in the retired CMS-HCC V24 model, which last determined payment in 2025, but it maps to no category in the live V28 model; see all codes that no longer risk-adjust. It still risk-adjusts in the PACE (CMS-HCC V22) category 134 (Dialysis Status), ESRD (V21) category 134 (Dialysis Status), ESRD (V24) category 134 (Dialysis Status), and RxHCC Part D (V08) category 261 (Dialysis Status, Including End Stage Renal Disease).