T85Not billable, use a more specific code below

Complications of other internal prosthetic devices, implants and grafts

In Complications of surgical and medical care, not elsewhere classified (T80-T88), chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes

288 billable codes under T85: 92 are a CC; none map to an HCC.A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment.

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Instructional notes

Excludes2: not included here, code separately if applicable

  • failure and rejection of transplanted organs and tissue (T86.-)

Also applies, from Complications of surgical and medical care, not elsewhere classified (T80-T88)

These notes sit on T80-T88 and apply to every code under it, including T85.

Excludes2: not included here, code separately if applicable

  • 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 for this, listed after this one

  • 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)

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

  • Section I.C.19.g Complications of care (page 85), covers T85

    Use T86 plus a code for the complication only when it affects transplanted organ function. Body system complication codes are sequenced first unless indexed to a T code, and device pain also gets G89.18 or G89.28.

Other Chapter 19 topics:

Read Section I.C.19 (page 77)

All codes under T85

T85 can't be used on a claim. Pick a billable code below; grey headings group them.

T85 MS-DRGs

As the principal diagnosis, the billable codes under T85 group to these 14 MS-DRGs (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

Other codes that refer to T85

Notes on these codes point to T85.

  • T81 Excludes2: complication of prosthetic devices, implants and grafts (T82-T85)
  • T88 Excludes2: complications of devices, implants and grafts (T82-T85)
  • Z96 Excludes2: complications of internal prosthetic devices, implants and grafts (T82-T85)
  • Z97 Excludes1: complications of internal prosthetic devices, implants and grafts (T82-T85)

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.