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I97.0 vs T84.85

I97.0 (Postcardiotomy syndrome) compared with T84.85 (Stenosis due to internal orthopedic prosthetic devices, implants and grafts), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).

Can these codes be reported together?

Yes, when both are documented. T84.85 carries an Excludes2 note covering I97.0: “functional disturbances following cardiac surgery (I97.0-I97.1)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

Side by side

I97.0Postcardiotomy syndromeT84.85Stenosis due to internal orthopedic prosthetic devices, implants and grafts
Billing statusBillableNon-billable header

Report instead: T84.85XA, T84.85XD, T84.85XS

ClassificationI00-I99 — Diseases of the Circulatory System (I00-I99)S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)
DefinitionPostcardiotomy syndrome is a billable ICD-10-CM diagnosis code (I97.0).Stenosis due to internal orthopedic prosthetic devices, implants and grafts is a non-billable ICD-10-CM category code (T84.85).
7th characterThe appropriate 7th character is to be added to each code from category T84
Use additional code
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)

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources