T85.3 vs Z44.2
T85.3 (Mechanical complication of other ocular prosthetic devices, implants and grafts) compared with Z44.2 (Encounter for fitting and adjustment of artificial eye), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.
Can these codes be reported together?
Yes, when both are documented. T85.3 carries an Excludes2 note covering Z44.2: “fitting and adjustment of external prosthetic device (Z44.-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
No — do not report together. Z44.2 carries an Excludes1 note covering T85.3: “mechanical complication of ocular prosthesis (T85.3)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
Side by side
| T85.3Mechanical complication of other ocular prosthetic devices, implants and grafts | Z44.2Encounter for fitting and adjustment of artificial eye | |
|---|---|---|
| Billing status | Non-billable header Report instead: T85.310A, T85.310D, T85.310S, T85.311A, T85.311D | 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 | Mechanical complication of other ocular prosthetic devices, implants and grafts is a non-billable ICD-10-CM category code (T85.3). | Encounter for fitting and adjustment of artificial eye is a non-billable ICD-10-CM category code (Z44.2). |
| 7th character | The appropriate 7th character is to be added to each code from category T85 | — |
| Includes | — | removal or replacement of external prosthetic device |
| 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) | — |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources