I97.2 vs T81
I97.2 (Postmastectomy lymphedema syndrome) compared with T81 (Complications of procedures, not elsewhere classified), 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. T81 carries an Excludes2 note covering I97.2: “postmastectomy lymphedema syndrome (I97.2)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| I97.2Postmastectomy lymphedema syndrome | T81Complications of procedures, not elsewhere classified | |
|---|---|---|
| Billing status | Billable | Non-billable header Report instead: T81.10XA, T81.10XD, T81.10XS, T81.11XA, T81.11XD |
| Classification | I00-I99 — Diseases of the Circulatory System (I00-I99) | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) |
| Definition | Postmastectomy lymphedema syndrome is a billable ICD-10-CM diagnosis code (I97.2). | Complications of procedures, not elsewhere classified is a non-billable ICD-10-CM category code (T81). |
| 7th character | — | The appropriate 7th character is to be added to each code from category T81 |
| Includes | Elephantiasis due to mastectomy Obliteration of lymphatic vessels | — |
| 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