2026 ICD-10-CM Diagnosis Code T85.614SBreakdown (mechanical) of insulin pump, sequela

ICD-10-CM Codes›S00–T88›T80-T88›T85

ICD-10-CM T85.614S
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

T85.614S is a billable ICD-10-CM diagnosis code for breakdown (mechanical) of insulin pump, sequela. The 7th character S marks it as a sequela code, which reports a problem that remains after the original condition has resolved. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 922 through 923. The code is exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Complication, sequela.

Code Identity

ICD-10-CM Code
T85.614S
Billable Status
Yes — Valid for Submission
Code Describes
Breakdown (mechanical) of insulin pump, sequela
Short Description
Breakdown (mechanical) of insulin pump, sequela
Same as the full description in the CMS dataset.
Parent Code
T85.614
Breakdown (mechanical) of insulin pump

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 CodeT85.614SBreakdown (mechanical) of insulin pump, sequela

Present on Admission (POA)Billing

T85.614S is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.

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 2026, published by CMS and the National Center for Health Statistics.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR INJ076
Complication, sequela
Default principal diagnosis: inpatient Yes · outpatient Yes

Convert T85.614S to ICD-9-CMHistory

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

ICD-9-CM
909.3 Late eff surg/med compl
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 T85.614SOverview

Is T85.614S (Breakdown (mechanical) of insulin pump) a billable code?

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

What does the 7th character S in T85.614S mean?

The final character S makes this a sequela code: it reports a lingering problem that remains after the breakdown (mechanical) of insulin pump itself has resolved, not the original event.

What MS-DRG does T85.614S group to?

When breakdown (mechanical) of insulin pump, sequela is the principal diagnosis on an inpatient stay, it groups to MS-DRG 922, 923, with relative weights from 1.0177 to 1.7494 depending on complications. Higher weights mean higher Medicare reimbursement.

Is T85.614S exempt from POA reporting?

Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for breakdown (mechanical) of insulin pump, sequela on inpatient claims.

What is the ICD-9 equivalent of T85.614S?

Under the General Equivalence Mappings, breakdown (mechanical) of insulin pump, sequela converts to ICD-9-CM 909.3 (late eff surg/med compl). The mapping is approximate, so confirm the match fits the documentation.