T85.633A (Leakage of insulin pump, initial encounter) compared with T85.633S (Leakage of insulin pump, sequela), from the official CMS tabular data. T85.633A and T85.633S 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. T85.633A and T85.633S 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.
| T85.633ALeakage of insulin pump, initial encounter | T85.633SLeakage of insulin pump, 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 | Leakage of insulin pump, initial encounter is a billable ICD-10-CM diagnosis code (T85.633A). | Leakage of insulin pump, sequela is a billable ICD-10-CM diagnosis code (T85.633S). |
| 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