T84.52XA (Infection and inflammatory reaction due to internal left hip prosthesis, initial encounter) compared with T84.52XS (Infection and inflammatory reaction due to internal left hip prosthesis, sequela), from the official CMS tabular data. T84.52XA and T84.52XS code the same injury at a different phase of treatment.
Same underlying diagnosis, different encounter phase.
The 7th character records the phase of care for the encounter being coded, so a single encounter takes one of these characters, not several. Review whether both phases belong on the same episode of care.
Source: ICD-10-CM Official Guidelines, Section I.C.19.a
Same injury, other encounter phase. T84.52XA and T84.52XS code the same injury at a different phase of treatment, set by the 7th character.
The 7th character records the type of care given at the encounter being coded (ICD-10-CM Official Guidelines, Section I.C.19.a), so one encounter takes one of these, not both.
| T84.52XAInfection and inflammatory reaction due to internal left hip prosthesis, initial encounter | T84.52XSInfection and inflammatory reaction due to internal left hip prosthesis, sequela | |
|---|---|---|
| Billing status | Billable | Billable |
| 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 and inflammatory reaction due to internal left hip prosthesis, initial encounter is a billable ICD-10-CM diagnosis code (T84.52A). | Infection and inflammatory reaction due to internal left hip prosthesis, sequela is a billable ICD-10-CM diagnosis code (T84.52S). |
| 7th character | The appropriate 7th character is to be added to each code from category T84 | The appropriate 7th character is to be added to each code from category T84 |
| 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 | 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