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T81.83XA ICD-10-CM Code: Persistent postprocedural fistula, initial encounter

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Inpatient Payment Groups (MS-DRG)

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, Appendix B.

  • MS-DRG 791 — PREMATURITY WITH MAJOR PROBLEMS (MDC 15)
  • MS-DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)
  • MS-DRG 919 — COMPLICATIONS OF TREATMENT WITH MCC (MDC 21)
  • MS-DRG 920 — COMPLICATIONS OF TREATMENT WITH CC (MDC 21)
  • MS-DRG 921 — COMPLICATIONS OF TREATMENT WITHOUT CC/MCC (MDC 21)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Official Registry Overview & Definition

Persistent postprocedural fistula, initial encounter is a billable ICD-10-CM diagnosis code (T81.83A).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for T81.83XA in the official ICD-10-CM tabular list.

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Code Also

Additional codes that may be required to fully describe the encounter.

  • Code also, if applicable, disruption of internal operation (surgical) wound (T81.32-)

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code, if known, for site of fistula such as:
  • anal fistula (K60.3-)
  • anorectal fistula (K60.5-)
  • bladder fistula (N32.2)
  • other female intestinal-genital tract fistulae (N82.4)
  • Use additional code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)
  • Use additional code(s) to identify the specified condition resulting from the complication
  • Use additional code to identify devices involved and details of circumstances (Y62-Y82)

Frequently Compared Codes

The official Excludes notes on T81.83XA name these codes. Each comparison page covers when the two can — or must not — be reported together.

Change history

No changes recorded for this code — unchanged since the FY2016 baseline of the change ledger.

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.

Relationships & Classification

Official ICD-10-CM tabular notes on other codes that name T81.83XA or its code family.

1 Excludes2 notes: T88 (via T81.-).

1 Code First instructions: J98.51 (via T81.-).

Potential MS-DRG Relationships (FY2026)

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 47 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.

Contextual Map

Every relationship of T81.83XA 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.

Hierarchy

  • S00-T88 — Chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) (S00-T88) [Hierarchy]
  • T80-T88 — Complications of surgical and medical care, not elsewhere classified [Hierarchy]

Referenced by Excludes2 notes

  • T88 — Other complications of surgical and medical care, not elsewhere classified [Excludes2](via T81.-): “complication following procedure NEC (T81.-)” · check together

Referenced by Code First instructions

  • J98.51 — Mediastinitis [Code First](via T81.-): “underlying condition, if applicable, such as postoperative mediastinitis (T81.-)” · check together

Clinical classification (CCSR)

  • INJ037 — Complication of other surgical or medical care, injury, initial encounter [CCSR]

Potential MS-DRG

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

MDC crossing · procedures (32029)

  • 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.”
  • 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.”
  • and 32029 more

Nearest codes (40)

  • T81 — Complications of procedures, not elsewhere classified [Sibling]
  • T81.710 — Complication of mesenteric artery following a procedure, not elsewhere classified [Sibling]
  • T81.710A — Complication of mesenteric artery following a procedure, not elsewhere classified, initial encounter [Sibling]
  • T81.710D — Complication of mesenteric artery following a procedure, not elsewhere classified, subsequent encounter [Sibling]
  • T81.710S — Complication of mesenteric artery following a procedure, not elsewhere classified, sequela [Sibling]
  • T81.711 — Complication of renal artery following a procedure, not elsewhere classified [Sibling]
  • T81.711A — Complication of renal artery following a procedure, not elsewhere classified, initial encounter [Sibling]
  • T81.711D — Complication of renal artery following a procedure, not elsewhere classified, subsequent encounter [Sibling]
  • and 32 more

Frequently Asked Questions (FAQ) & Clinical Guidance

Does T81.83XA require a 7th character?

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

Nearest Codes in This Family

Official ICD-10-CM classifications closest to T81.83XA in its code family, with their registry titles.

  • T81.82 — Emphysema (subcutaneous) resulting from a procedure
  • T81.82XA — Emphysema (subcutaneous) resulting from a procedure, initial encounter
  • T81.82XD — Emphysema (subcutaneous) resulting from a procedure, subsequent encounter
  • T81.82XS — Emphysema (subcutaneous) resulting from a procedure, sequela
  • T81.83 — Persistent postprocedural fistula
  • T81.83XD — Persistent postprocedural fistula, subsequent encounter
  • T81.83XS — Persistent postprocedural fistula, sequela
  • T81.89 — Other complications of procedures, not elsewhere classified
  • T81.89XA — Other complications of procedures, not elsewhere classified, initial encounter
  • T81.89XD — Other complications of procedures, not elsewhere classified, subsequent encounter

View all codes in the T81 family