T85.318A vs T85.318D
T85.318A (Breakdown (mechanical) of other ocular prosthetic devices, implants and grafts, initial encounter) compared with T85.318D (Breakdown (mechanical) of other ocular prosthetic devices, implants and grafts, subsequent encounter), from the official CMS tabular data. T85.318A and T85.318D code the same injury at a different phase of treatment.
Can these codes be reported together?
Same injury, other encounter phase. T85.318A and T85.318D 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.
Side by side
| T85.318ABreakdown (mechanical) of other ocular prosthetic devices, implants and grafts, initial encounter | T85.318DBreakdown (mechanical) of other ocular prosthetic devices, implants and grafts, subsequent encounter | |
|---|---|---|
| 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 other ocular prosthetic devices, implants and grafts, initial encounter is a billable ICD-10-CM diagnosis code (T85.318A). | Breakdown (mechanical) of other ocular prosthetic devices, implants and grafts, subsequent encounter is a billable ICD-10-CM diagnosis code (T85.318D). |
| 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 |
| 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