T81.83XA vs T82
T81.83XA (Persistent postprocedural fistula, initial encounter) compared with T82 (Complications of cardiac and vascular 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. T81.83XA carries an Excludes2 note covering T82: “complication of prosthetic devices, implants and grafts (T82-T85)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| T81.83XAPersistent postprocedural fistula, initial encounter | T82Complications of cardiac and vascular prosthetic devices, implants and grafts | |
|---|---|---|
| Billing status | Billable | Non-billable header Report instead: T82.01XA, T82.01XD, T82.01XS, T82.02XA, T82.02XD |
| 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 | Persistent postprocedural fistula, initial encounter is a billable ICD-10-CM diagnosis code (T81.83A). | Complications of cardiac and vascular prosthetic devices, implants and grafts is a non-billable ICD-10-CM category code (T82). |
| 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 T82 |
| Use additional code | code, if known, for site of fistula such as: anal fistula (K60.3-) anorectal fistula (K60.5-) | 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