Version 2024

2024 ICD-10-CM Diagnosis Code T84.498S

Other mechanical complication of other internal orthopedic devices, implants and grafts, sequela

ICD-10-CM Code:: T84.498S
ICD-10 Code for:: Mech compl of int orth devices, implnt and grafts, sequela
Is Billable?: Yes - Valid for Submission
Code Navigator:

Code Information
Approximate Synonyms
Clinical Classification
Coding Guidelines
Tabular List of Diseases and Injuries
Diagnostic Related Groups Mapping
Present on Admission (POA)
Convert to ICD-9 Code
Patient Education
Other Codes Used Similar Conditions
Code History

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 internal orthopedic prosthetic devices, implants and grafts
    (T84)

T84.498S is a billable diagnosis code used to specify a medical diagnosis of other mechanical complication of other internal orthopedic devices, implants and grafts, sequela. 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.

T84.498S is a sequela code, includes a 7th character and should be used for complications that arise as a direct result of a condition like other mechanical complication of other internal orthopedic devices implants and grafts. According to ICD-10-CM Guidelines a "sequela" code should be used for chronic or residual conditions that are complications of an initial acute disease, illness or injury. The most common sequela is pain. Usually, two diagnosis codes are needed when reporting sequela. The first code describes the nature of the sequela while the second code describes the sequela or late effect.

Approximate Synonyms

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

Bending of bone fixation device
Bending of bone fixation device
Bending of bone fixation device
Bending of bone fixation device
Bending of bone fixation device
Bending of external fixator
Bending of intramedullary nail
Bending of plate
Bending of screw
Bending of spinal fixation device
Bone fixation device protrusion
Bone fixation device protrusion
Bone fixation device protrusion
Bone fixation device protrusion
Bone fixation device protrusion
Breakage of bone fixation device
Breakage of bone fixation device
Breakage of bone fixation device
Breakage of bone fixation device
Breakage of bone fixation device
Breakage of bone fixation device
Breakage of bone plate
Breakage of bone screw
Breakage of external fixator
Breakage of intramedullary nail
Breakage of spinal fixation device
Breakage of wire
Disorder of cartilage graft
Loosening of musculoskeletal implant
Loosening of orthopedic device
Mechanical complication associated with orthopedic device
Mechanical complication of cartilage graft
Mechanical complication of internal orthopedic device
Mechanical complication of musculoskeletal implant
Prominence of intramedullary nail
Prominence of plate
Prominence of screw
Prominence of spinal fixation device
Prominence of wire
Protrusion of musculoskeletal implant

Clinical Classification

Clinical Category is Complication, sequela
CCSR Category Code: INJ076
Inpatient Default CCSR: Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.
Outpatient Default CCSR: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.

Coding Guidelines

The appropriate 7th character is to be added to each code from block Complications of internal orthopedic prosthetic devices, implants and grafts (T84). Use the following options for the aplicable episode of care:

A - initial encounter
D - subsequent encounter
S - sequela

T84.498S is grouped with Diagnostic Related Groups - MS-DRG Mapping

Diagnostic Related Groups (DRGs) are a classification system used to group together diagnosis codes for the purpose of reimbursement and healthcare management. DRGs are used to standardize the way hospitals and other providers are paid for inpatient services. In this system patients are grouped together based on their principal diagnosis in areas referred to as Major Diagnostic Categories (MDC). Once a patient is assigned a particular diagnostic category, providers receive a predetermined payment rate for the services rendered. This reimbursement rate is often fixed and is meant to cover the cost of care for that patient. Reimbursement is also affected by the relative weight of a diagnostic related group based on the severity of a patient's illness and the associated cost of care during hospitalization.

Diagnostic related groups encourage healthcare providers to focus on quality and efficiency in patient care while managing costs effectively. The diagnosis code is present in the following groups for version MS-DRG V41.0 applicable from 10/01/2023 through 09/30/2024.

MS-DRG	MS-DRG Title	MCD	Relative Weight
922	OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC	21	1.7449
923	OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC	21	1.0114

The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.

Present on Admission (POA)

T84.498S 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 Indicator	Reason for Code	CMS will pay the CC/MCC DRG?
Y	Diagnosis was present at time of inpatient admission.	YES
N	Diagnosis was not present at time of inpatient admission.	NO
U	Documentation insufficient to determine if the condition was present at the time of inpatient admission.	NO
W	Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.	YES
1	Unreported/Not used - Exempt from POA reporting.	NO

Convert T84.498S to ICD-9-CM

ICD-9-CM Code: 909.3 - Late eff surg/med compl
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.

Other ICD-10-CM Codes Commonly Used for Similar Conditions

Filter related codes list:

T84 Complications of internal orthopedic prosthetic devices, implants and grafts.
T84.0 Mechanical complication of internal joint prosthesis.
T84.01 Broken internal joint prosthesis.
T84.010 Broken internal right hip prosthesis.
T84.010A Broken internal right hip prosthesis, initial encounter.
T84.010D Broken internal right hip prosthesis, subsequent encounter.
T84.010S Broken internal right hip prosthesis, sequela.
T84.011 Broken internal left hip prosthesis.
T84.011A Broken internal left hip prosthesis, initial encounter.
T84.011D Broken internal left hip prosthesis, subsequent encounter.
T84.011S Broken internal left hip prosthesis, sequela.
T84.012 Broken internal right knee prosthesis.
T84.012A Broken internal right knee prosthesis, initial encounter.
T84.012D Broken internal right knee prosthesis, subsequent encounter.
T84.012S Broken internal right knee prosthesis, sequela.
T84.013 Broken internal left knee prosthesis.
T84.013A Broken internal left knee prosthesis, initial encounter.
T84.013D Broken internal left knee prosthesis, subsequent encounter.
T84.013S Broken internal left knee prosthesis, sequela.
T84.018 Broken internal joint prosthesis, other site.
T84.018A Broken internal joint prosthesis, other site, initial encounter.
T84.018D Broken internal joint prosthesis, other site, subsequent encounter.
T84.018S Broken internal joint prosthesis, other site, sequela.
T84.019 Broken internal joint prosthesis, unspecified site.
T84.019A Broken internal joint prosthesis, unspecified site, initial encounter.
T84.019D Broken internal joint prosthesis, unspecified site, subsequent encounter.
T84.019S Broken internal joint prosthesis, unspecified site, sequela.
T84.02 Dislocation of internal joint prosthesis.
T84.020 Dislocation of internal right hip prosthesis.
T84.020A Dislocation of internal right hip prosthesis, initial encounter.
T84.020D Dislocation of internal right hip prosthesis, subsequent encounter.
T84.020S Dislocation of internal right hip prosthesis, sequela.
T84.021 Dislocation of internal left hip prosthesis.
T84.021A Dislocation of internal left hip prosthesis, initial encounter.
T84.021D Dislocation of internal left hip prosthesis, subsequent encounter.
T84.021S Dislocation of internal left hip prosthesis, sequela.
T84.022 Instability of internal right knee prosthesis.
T84.022A Instability of internal right knee prosthesis, initial encounter.
T84.022D Instability of internal right knee prosthesis, subsequent encounter.
T84.022S Instability of internal right knee prosthesis, sequela.
T84.023 Instability of internal left knee prosthesis.
T84.023A Instability of internal left knee prosthesis, initial encounter.
T84.023D Instability of internal left knee prosthesis, subsequent encounter.
T84.023S Instability of internal left knee prosthesis, sequela.
T84.028 Dislocation of other internal joint prosthesis.
T84.028A Dislocation of other internal joint prosthesis, initial encounter.
T84.028D Dislocation of other internal joint prosthesis, subsequent encounter.
T84.028S Dislocation of other internal joint prosthesis, sequela.
T84.029 Dislocation of unspecified internal joint prosthesis.
T84.029A Dislocation of unspecified internal joint prosthesis, initial encounter.
T84.029D Dislocation of unspecified internal joint prosthesis, subsequent encounter.

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
FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.