I97.0 vs T85
I97.0 (Postcardiotomy syndrome) compared with T85 (Complications of other internal 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. T85 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 syndrome | T85Complications of other internal prosthetic devices, implants and grafts | |
|---|---|---|
| Billing status | Billable | Non-billable header Report instead: T85.01XA, T85.01XD, T85.01XS, T85.02XA, T85.02XD |
| Classification | I00-I99 — Diseases of the Circulatory System (I00-I99) | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) |
| Definition | Postcardiotomy syndrome is a billable ICD-10-CM diagnosis code (I97.0). | Complications of other internal prosthetic devices, implants and grafts is a non-billable ICD-10-CM category code (T85). |
| 7th character | — | The appropriate 7th character is to be added to each code from category T85 |
| 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