T85.113A (Breakdown (mechanical) of implanted electronic neurostimulator, generator, initial encounter) compared with T85.113S (Breakdown (mechanical) of implanted electronic neurostimulator, generator, sequela), from the official CMS tabular data. T85.113A and T85.113S 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. T85.113A and T85.113S 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.
| T85.113ABreakdown (mechanical) of implanted electronic neurostimulator, generator, initial encounter | T85.113SBreakdown (mechanical) of implanted electronic neurostimulator, generator, 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 | Breakdown (mechanical) of implanted electronic neurostimulator, generator, initial encounter is a billable ICD-10-CM diagnosis code (T85.113A). | Breakdown (mechanical) of implanted electronic neurostimulator, generator, sequela is a billable ICD-10-CM diagnosis code (T85.113S). |
| 7th character | The appropriate 7th character is to be added to each code from category T85 | The appropriate 7th character is to be added to each code from category T85 |
| Includes | Breakdown (mechanical) of implanted electronic neurostimulator generator, brain, peripheral, gastric, spinal Breakdown (mechanical) of implanted electronic sacral neurostimulator, pulse generator or receiver | Breakdown (mechanical) of implanted electronic neurostimulator generator, brain, peripheral, gastric, spinal Breakdown (mechanical) of implanted electronic sacral neurostimulator, pulse generator or receiver |
| 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