T81.4 vs T84.5
T81.4 (Infection following a procedure) compared with T84.5 (Infection and inflammatory reaction due to internal joint prosthesis), 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. T81.4 carries an Excludes2 note covering T84.5: “infection due to prosthetic devices, implants and grafts (T82.6-T82.7, T83.5-T83.6, T84.5-T84.7, T85.7)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| T81.4Infection following a procedure | T84.5Infection and inflammatory reaction due to internal joint prosthesis | |
|---|---|---|
| Billing status | Non-billable header Report instead: T81.40XA, T81.40XD, T81.40XS, T81.41XA, T81.41XD | Non-billable header Report instead: T84.50XA, T84.50XD, T84.50XS, T84.51XA, T84.51XD |
| Classification | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) |
| Definition | Infection following a procedure is a non-billable ICD-10-CM category code (T81.4). | Infection and inflammatory reaction due to internal joint prosthesis is a non-billable ICD-10-CM category code (T84.5). |
| 7th character | The appropriate 7th character is to be added to each code from category T81 | The appropriate 7th character is to be added to each code from category T84 |
| Includes | Wound abscess following a procedure | — |
| Use additional code | code to identify infection code (R65.2-) to identify severe sepsis, if applicable code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5) | 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