T85.738A vs T85.738D
T85.738A (Infection and inflammatory reaction due to other nervous system device, implant or graft, initial encounter) compared with T85.738D (Infection and inflammatory reaction due to other nervous system device, implant or graft, subsequent encounter), from the official CMS tabular data. T85.738A and T85.738D code the same injury at a different phase of treatment.
Can these codes be reported together?
Same injury, other encounter phase. T85.738A and T85.738D 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
| T85.738AInfection and inflammatory reaction due to other nervous system device, implant or graft, initial encounter | T85.738DInfection and inflammatory reaction due to other nervous system device, implant or graft, 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 | Infection and inflammatory reaction due to other nervous system device, implant or graft, initial encounter is a billable ICD-10-CM diagnosis code (T85.738A). | Infection and inflammatory reaction due to other nervous system device, implant or graft, subsequent encounter is a billable ICD-10-CM diagnosis code (T85.738D). |
| 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 | Infection and inflammatory reaction due to intrathecal infusion pump | Infection and inflammatory reaction due to intrathecal infusion pump |
| Use additional code | code to identify infection 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 infection 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 |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources