T81.60XA ICD-10-CM Code: Unspecified acute reaction to foreign substance accidentally left during a procedure, initial encounter

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for T81.60XA in the official ICD-10-CM tabular list, quoted as published.

Notes without a marker are published on T81.60XA itself; “inherited from” names the category or block whose note applies here.

7th Character Guide

"The appropriate 7th character is to be added to each code from category T81"

• A — initial encounter (this page’s code)
• D — subsequent encounter
• S — sequela

How the encounter character is assigned. “Initial encounter” means the patient is receiving active treatment for the condition — it is not limited to the first visit, and a different or new provider giving active treatment still assigns it. “Subsequent encounter” covers care during the healing or recovery phase after active treatment. “Sequela” is for complications or conditions that arise as a direct result of the original condition.

ICD-10-CM Official Guidelines for Coding and Reporting, Section I.C.19.a (paraphrased by MedCoder).

Variant codes in this family

T81.60XA, T81.60XD, T81.60XS

Character meanings are CMS's official 7th-character extensions for this family, as carried in each variant code's official description; variant codes are registry rows. The explanation of how the encounter character is assigned is MedCoder editorial, distinct from the official content above it.

Coder workflow for T81.60XA

MedCoder structured workflow — derived from this code’s own official record

Before you code T81.60XA

1. Unspecified does not mean incorrect. When the record gives no greater specificity, T81.60XA may be the appropriate code. Check the record for detail that supports a more specific sibling — in this subcategory the siblings differ by acute versus chronic. An unspecified code is for records that do not provide the detail a more specific code needs; a query, not an assumption, is the route to specificity (Guidelines I.A.9.b, I.B.18).

   See the relationships section · Guide: Other vs unspecified (NEC vs NOS) →

2. A 7th character is required in this family. Confirm the documented encounter: initial (active treatment), subsequent (healing or recovery phase), or sequela. This page’s code carries “A”. “Initial” means active treatment, not the first visit (Guidelines I.C.19.a).

   See the 7th Character Guide · Guide: 7th characters: initial, subsequent, sequela →

3. Laterality is coded in this family. Confirm the side documented — right, left, or bilateral — and select the matching code (this page’s code: left). The unspecified-side code applies only when the record states no side. Laterality is assigned from the documented side; where a bilateral code exists and both sides are documented, it is used instead of two unilateral codes (Guidelines I.B.13).

   See the relationships section · Guide: Laterality coding →

Choose the right path

1. Does the record document the detail a more specific sibling code needs?
   Yes → Review the specific siblings in this subcategory.
   No → Continue — T81.60XA is appropriate when the documentation goes no further.
2. Is the side documented?
   Yes → Select the code for the documented side (or the bilateral code when both sides are documented and one exists).
   No → Use the unspecified-side code only when the record states no side; a query is the alternative.
3. Is the encounter phase documented — active treatment, healing or recovery, or a sequela?
   Yes → Assign the matching 7th character; the variant codes are in the 7th Character Guide.
   No → The code is invalid without its 7th character — query for the missing element.

Consider T81.60XA. Then work the Use Additional Code note, and confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement

Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).

Laterality

Right, left or bilateral as documented; unspecified only when the record states no side (Guidelines I.B.13).

Encounter type

Active treatment, healing or recovery phase, or sequela — the basis of the 7th character (Guidelines I.C.19.a).

Acuity

Acute or chronic as documented; when both are documented and separate codes exist, both are reported with the acute code first (Guidelines I.B.8).

The conditions the Use Additional Code note names

Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.

Any detail beyond this code’s title

What the record states that a more specific sibling code would capture — or its absence, which itself supports the unspecified code.

Official instructions as workflow

• Excludes2 — not part of T81.60XA(32 notes)

  Coding workflow: The conditions named in this note are not included in T81.60XA. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

  CompareT81.5, T80, T86, L23.3, L24.4, L25.1

  See the official tabular notes · Guidelines I.A.12.b

• Use Additional Code — after identifying T81.60XA(3 notes)

  Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with T81.60XA when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.

  See the official tabular notes · Guidelines I.A.13

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse T81.60XA with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of T81.60XA — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

• T81.60XD— Encounter relationship (Review)

  Same underlying diagnosis, different encounter phase.

  The same diagnosis at a different phase of care; one encounter takes one 7th character.

  What moves you there: Documentation of a subsequent encounter moves the case to T81.60XD.

  Full comparison: T81.60XA vs T81.60XD →

• T81.60XS— Encounter relationship (Review)

  Same underlying diagnosis, different encounter phase.

  The same diagnosis at a different phase of care; one encounter takes one 7th character.

  What moves you there: Documentation of a sequela moves the case to T81.60XS.

  Full comparison: T81.60XA vs T81.60XS →

• T81.5— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of complications of foreign body accidentally left in body cavity or operation wound following procedure adds T81.5; it is not part of this code and both may be reported when both are documented.

  Full comparison: T81.60XA vs T81.5 →

• T88.0— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of complications following immunization adds T88.0; it is not part of this code and both may be reported when both are documented.

  Full comparison: T81.60XA vs T88.0 →

• T88.1— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of complications following immunization adds T88.1; it is not part of this code and both may be reported when both are documented.

  Full comparison: T81.60XA vs T88.1 →

• T80— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of complications following infusion, transfusion and therapeutic injection adds T80; it is not part of this code and both may be reported when both are documented.

  Full comparison: T81.60XA vs T80 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Decision Points

The directives on this code's own record, as a pre-claim checklist.

1. A 7th character applies in this family. Confirm the documented encounter matches the character assigned. See the official 7th-character definitions and this code’s variants
2. Laterality is coded in this family. Confirm the documented side matches the code — the opposite-side siblings are in the relationships section. See the opposite-side sibling codes
3. 3 Use Additional Code instructions — report the named additional code(s) when the documentation supports them. See the Use Additional Code notes
4. 32 Excludes2 entries — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

Verify Before Coding

• CC as a secondary diagnosis (FY2026). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name T81.60XA or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Excludes1 note: T88.7 — Unspecified adverse effect of drug or medicament (via T81.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 3 Excludes2 notes: T78 — Adverse effects, not elsewhere classified (via T81.-), T79 — Certain early complications of trauma, not elsewhere classified (via T81.-), T88 — Other complications of surgical and medical care, not elsewhere classified (via T81.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Referenced by 1 Code First instruction: J98.51 — Mediastinitis (via T81.-).

Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 49 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 5 MS-DRGs: DRG 791 (MDC 15), DRG 793 (MDC 15), DRG 919 (MDC 21), DRG 920 (MDC 21), DRG 921 (MDC 21).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):INJ037 — Complication of other surgical or medical care, injury, initial encounter (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical process (MS-DRG)

Acts as CC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.

H95.811 — Postprocedural stenosis of right external ear canal, H95.812 — Postprocedural stenosis of left external ear canal, H95.813 — Postprocedural stenosis of external ear canal, bilateral, H95.819 — Postprocedural stenosis of unspecified external ear canal, H95.88 — Other intraoperative complications and disorders of the ear and mastoid process, not elsewhere classified, H95.89 — Other postprocedural complications and disorders of the ear and mastoid process, not elsewhere classified, I97.3 — Postprocedural hypertension, L76.81 — Other intraoperative complications of skin and subcutaneous tissue, L76.82 — Other postprocedural complications of skin and subcutaneous tissue, M96.89 — Other intraoperative and postprocedural complications and disorders of the musculoskeletal system, N98.1 — Hyperstimulation of ovaries, N98.2 — Complications of attempted introduction of fertilized ovum following in vitro fertilization, N98.3 — Complications of attempted introduction of embryo in embryo transfer, N98.8 — Other complications associated with artificial fertilization, N98.9 — Complication associated with artificial fertilization, unspecified, T81.61XA — Aseptic peritonitis due to foreign substance accidentally left during a procedure, initial encounter, T81.69XA — Other acute reaction to foreign substance accidentally left during a procedure, initial encounter, T81.82XA — Emphysema (subcutaneous) resulting from a procedure, initial encounter, T81.89XA — Other complications of procedures, not elsewhere classified, initial encounter, T81.9XXA — Unspecified complication of procedure, initial encounter, +28 more

Same injury, other encounter phase

Same injury, coded at a different phase of treatment via the 7th character.

T81.60XD — Unspecified acute reaction to foreign substance accidentally left during a procedure, subsequent encounterCompare T81.60XA vs T81.60XD →, T81.60XS — Unspecified acute reaction to foreign substance accidentally left during a procedure, sequelaCompare T81.60XA vs T81.60XS →

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Complication of other surgical or medical care, injury, initial encounter).

T81.590A — Other complications of foreign body accidentally left in body following surgical operation, initial encounter, T81.591A — Other complications of foreign body accidentally left in body following infusion or transfusion, initial encounter, T81.592A — Other complications of foreign body accidentally left in body following kidney dialysis, initial encounter, T81.593A — Other complications of foreign body accidentally left in body following injection or immunization, initial encounter, T81.594A — Other complications of foreign body accidentally left in body following endoscopic examination, initial encounter, T81.595A — Other complications of foreign body accidentally left in body following heart catheterization, initial encounter, T81.596A — Other complications of foreign body accidentally left in body following aspiration, puncture or other catheterization, initial encounter, T81.597A — Other complications of foreign body accidentally left in body following removal of catheter or packing, initial encounter, T81.598A — Other complications of foreign body accidentally left in body following other procedure, initial encounter, T81.599A — Other complications of foreign body accidentally left in body following unspecified procedure, initial encounter, T81.61XA — Aseptic peritonitis due to foreign substance accidentally left during a procedure, initial encounter, T81.69XA — Other acute reaction to foreign substance accidentally left during a procedure, initial encounter, T81.710A — Complication of mesenteric artery following a procedure, not elsewhere classified, initial encounter, T81.711A — Complication of renal artery following a procedure, not elsewhere classified, initial encounter, T81.718A — Complication of other artery following a procedure, not elsewhere classified, initial encounter, T81.719A — Complication of unspecified artery following a procedure, not elsewhere classified, initial encounter, T81.72XA — Complication of vein following a procedure, not elsewhere classified, initial encounter, T81.81XA — Complication of inhalation therapy, initial encounter, T81.82XA — Emphysema (subcutaneous) resulting from a procedure, initial encounter, T81.83XA — Persistent postprocedural fistula, initial encounter, +230 more

Contextual Map

Every relationship of T81.60XA in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run T81.60XA with these 5 related codes in Claim Check

Hierarchy

• S00-T88 — Chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) (S00-T88)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• T80-T88 — Complications of surgical and medical care, not elsewhere classified[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Referenced by Excludes1 notes

• T88.7 — Unspecified adverse effect of drug or medicament[Excludes1](via T81.-): “specified adverse effects of drugs and medicaments (A00-R94 and T80-T88.6, T88.8)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Excludes2 notes

• T78 — Adverse effects, not elsewhere classified[Excludes2](via T81.-): “complications of surgical and medical care NEC (T80-T88)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• T79 — Certain early complications of trauma, not elsewhere classified[Excludes2](via T81.-): “complications occurring during or following medical procedures (T80-T88)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• T88 — Other complications of surgical and medical care, not elsewhere classified[Excludes2](via T81.-): “complication following procedure NEC (T81.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Code First instructions

• J98.51 — Mediastinitis[Code First](via T81.-): “underlying condition, if applicable, such as postoperative mediastinitis (T81.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Clinical classification (CCSR)

• INJ037 — Complication of other surgical or medical care, injury, initial encounter[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)

MS-DRG Grouper

• CC — Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (CC).”— CMS MS-DRG Definitions Manual (Appendix C) · FY2026
• DRG 791 — PREMATURITY WITH MAJOR PROBLEMS[MS-DRG]: “PREMATURITY WITH MAJOR PROBLEMS (MDC 15)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS[MS-DRG]: “FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 919 — COMPLICATIONS OF TREATMENT WITH MCC[MS-DRG]: “COMPLICATIONS OF TREATMENT WITH MCC (MDC 21)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 920 — COMPLICATIONS OF TREATMENT WITH CC[MS-DRG]: “COMPLICATIONS OF TREATMENT WITH CC (MDC 21)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 921 — COMPLICATIONS OF TREATMENT WITHOUT CC/MCC[MS-DRG]: “COMPLICATIONS OF TREATMENT WITHOUT CC/MCC (MDC 21)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026

MDC crossing

• MDC 15 — Newborns and Other Neonates with Conditions Originating in Perinatal Period[MDC crossing]: “Newborns and Other Neonates with Conditions Originating in Perinatal Period — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”— CMS MS-DRG Definitions Manual · FY2026
• MDC 21 — Injuries, Poisonings and Toxic Effects of Drugs[MDC crossing]: “Injuries, Poisonings and Toxic Effects of Drugs — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 32,029 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Nearest codes (40)

• T81 — Complications of procedures, not elsewhere classified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• T81.595D — Other complications of foreign body accidentally left in body following heart catheterization, subsequent encounter[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• T81.595S — Other complications of foreign body accidentally left in body following heart catheterization, sequela[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• T81.596 — Other complications of foreign body accidentally left in body following aspiration, puncture or other catheterization[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• T81.596A — Other complications of foreign body accidentally left in body following aspiration, puncture or other catheterization, initial encounter[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• T81.596D — Other complications of foreign body accidentally left in body following aspiration, puncture or other catheterization, subsequent encounter[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• T81.596S — Other complications of foreign body accidentally left in body following aspiration, puncture or other catheterization, sequela[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• T81.597 — Other complications of foreign body accidentally left in body following removal of catheter or packing[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• and 32 more

Change history

• FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Common coding questions

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data

CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page

Claim edits Official source data

CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page

Inpatient payment groups Official source data

CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page

Change history and date-of-service validity Official source data

CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page

Comparisons, relationships and the contextual map MedCoder structured relationship

Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears

Summary and FAQ answers MedCoder explanation

Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Nearest Codes in This Family

Official ICD-10-CM classifications closest to T81.60XA in its code family, with their registry titles.

• T81.599A — Other complications of foreign body accidentally left in body following unspecified procedure, initial encounter
• T81.599D — Other complications of foreign body accidentally left in body following unspecified procedure, subsequent encounter
• T81.599S — Other complications of foreign body accidentally left in body following unspecified procedure, sequela
• T81.6 — Acute reaction to foreign substance accidentally left during a procedure
• T81.60 — Unspecified acute reaction to foreign substance accidentally left during a procedure
• T81.60XD — Unspecified acute reaction to foreign substance accidentally left during a procedure, subsequent encounter
• T81.60XS — Unspecified acute reaction to foreign substance accidentally left during a procedure, sequela
• T81.61 — Aseptic peritonitis due to foreign substance accidentally left during a procedure
• T81.61XA — Aseptic peritonitis due to foreign substance accidentally left during a procedure, initial encounter
• T81.61XD — Aseptic peritonitis due to foreign substance accidentally left during a procedure, subsequent encounter

View all codes in the T81 family