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T84.012A vs T84.013A

T84.012A (Broken internal right knee prosthesis, initial encounter) compared with T84.013A (Broken internal left knee prosthesis, initial encounter), from the official CMS tabular data. T84.012A and T84.013A code the same condition on opposite sides.

Relationship

Review

Laterality relationship

T84.012A
Right
Broken internal right knee prosthesis, initial encounter
T84.013A
Left
Broken internal left knee prosthesis, initial encounter

Same condition; these differ only in which side is documented.

These codes share a category and title and differ only in the side affected. The documentation decides which applies, and a bilateral code is reported only where the code set provides one.

Source: ICD-10-CM tabular list (laterality variant derived from the code title)

Can these codes be reported together?

Same condition, opposite side. T84.012A and T84.013A name the same condition on opposite sides of the body.

Same category and title, differing only in which side is affected — the documentation decides which one applies, and a bilateral code is reported only where the code set provides one.

Side by side

T84.012ABroken internal right knee prosthesis, initial encounterT84.013ABroken internal left knee prosthesis, initial encounter
Billing statusBillableBillable
ClassificationS00-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)
DefinitionBroken internal right knee prosthesis, initial encounter is a billable ICD-10-CM diagnosis code (T84.012A).Broken internal left knee prosthesis, initial encounter is a billable ICD-10-CM diagnosis code (T84.013A).
7th characterThe appropriate 7th character is to be added to each code from category T84The appropriate 7th character is to be added to each code from category T84
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)
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