M96.1 vs T85.738D
M96.1 (Postlaminectomy syndrome, not elsewhere classified) compared with T85.738D (Infection and inflammatory reaction due to other nervous system device, implant or graft, subsequent encounter), 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. T85.738D carries an Excludes2 note covering M96.1: “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.-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Yes, when both are documented. T85.738D carries an Excludes2 note covering M96.1: “postlaminectomy syndrome NEC (M96.1)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| M96.1Postlaminectomy syndrome, not elsewhere classified | T85.738DInfection and inflammatory reaction due to other nervous system device, implant or graft, subsequent encounter | |
|---|---|---|
| Billing status | Billable | Billable |
| Classification | M00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99) | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) |
| Definition | Postlaminectomy syndrome, not elsewhere classified is a billable ICD-10-CM diagnosis code (M96.1). | Infection and inflammatory reaction due to other nervous system device, implant or graft, subsequent encounter is a billable ICD-10-CM diagnosis code (T85.738D). |
| 7th character | — | The appropriate 7th character is to be added to each code from category T85 |
| Includes | — | Infection and inflammatory reaction due to intrathecal infusion pump |
| Use additional code | — | code to identify infection 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 |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources