2027 ICD-10-CM Diagnosis Code T85.9XXAUnspecified complication of internal prosthetic device, implant and graft, initial encounter
T85.9XXA is a billable ICD-10-CM diagnosis code for unspecified complication of internal prosthetic device, implant and graft, 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. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Complication of other surgical or medical care, injury, initial encounter.
Code Identity
Code Classification
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this 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 peritoneal dialysis
- Complication of reimplant
- Device failure
- Disorder associated with implant
- Disorder associated with surgical mesh
- Disorder due to grafting procedure
- Disorder following grafting procedure
- 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 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 prostheses and implants of the eye
- Disorders of prostheses and implants of the nervous system
- Failed subcutaneous contraceptive insertion
- Finding of respiratory device
- Malposition of neurostimulator generator
- Tissue expander disorder
- Urinary tract internal anastomosis complication
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 T85.9XXA: its own notes plus those printed at T85, block T80-T88, and Chapter 19. A note printed at a category, block or chapter applies to every code under it.
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.
- failure and rejection of transplanted organs and tissue (T86.-)
- 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)
Use Additional Code
Add a second code, after this one, to fully describe the condition.
- code to identify any retained foreign body, if applicable (Z18.-)
Notes
General instructions on how these codes are used.
- 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.
- The appropriate 7th character is to be added to each code from category T85
- Ainitial encounter this code
- Dsubsequent encounter
- Ssequela
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Convert T85.9XXA to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About T85.9XXAOverview
Is T85.9XXA a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report unspecified complication of internal prosthetic device, implant and graft, initial encounter on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What does the 7th character A in T85.9XXA mean?
The final character A marks the initial encounter: use it while the patient is receiving active treatment for unspecified complication of internal prosthetic device, implant and graft, such as an emergency visit or first evaluation.
What MS-DRG does T85.9XXA group to?
When unspecified complication of internal prosthetic device, implant and graft, 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.
What is the ICD-9 equivalent of T85.9XXA?
Under the General Equivalence Mappings, unspecified complication of internal prosthetic device, implant and graft, initial encounter converts to ICD-9-CM 996.70 (comp-unsp device/graft). The mapping is approximate, so confirm the match fits the documentation.