T81.83XA vs Z43
T81.83XA (Persistent postprocedural fistula, initial encounter) compared with Z43 (Encounter for attention to artificial openings), 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 Z43: “closure of external stoma (Z43.-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| T81.83XAPersistent postprocedural fistula, initial encounter | Z43Encounter for attention to artificial openings | |
|---|---|---|
| Billing status | Billable | Non-billable header |
| Classification | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) | Z00-Z99 — Factors Influencing Health Status and Contact with Health Services (Z00-Z99) |
| Definition | Persistent postprocedural fistula, initial encounter is a billable ICD-10-CM diagnosis code (T81.83A). | Encounter for attention to artificial openings is a non-billable ICD-10-CM category code (Z43). |
| 7th character | The appropriate 7th character is to be added to each code from category T81 | — |
| Includes | — | closure of artificial openings passage of sounds or bougies through artificial openings reforming artificial openings removal of catheter from artificial openings |
| Use additional code | code, if known, for site of fistula such as: anal fistula (K60.3-) anorectal fistula (K60.5-) | — |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources