T85.63 vs Z43
T85.63 (Leakage of other specified internal prosthetic devices, implants and grafts) compared with Z43 (Encounter for attention to artificial openings), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).
Can these codes be reported together?
Yes, when both are documented. T85.63 carries an Excludes2 note covering Z43: “closure of external stoma (Z43.-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| T85.63Leakage of other specified internal prosthetic devices, implants and grafts | Z43Encounter for attention to artificial openings | |
|---|---|---|
| Billing status | Non-billable header Report instead: T85.630A, T85.630D, T85.630S, T85.631A, T85.631D | 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 | Leakage of other specified internal prosthetic devices, implants and grafts is a non-billable ICD-10-CM category code (T85.63). | Encounter for attention to artificial openings is a non-billable ICD-10-CM category code (Z43). |
| 7th character | The appropriate 7th character is to be added to each code from category T85 | — |
| Includes | — | closure of artificial openings passage of sounds or bougies through artificial openings reforming artificial openings removal of catheter from artificial openings |
| 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