T83.61XA ICD-10-CM Code: Infection and inflammatory reaction due to implanted penile prosthesis, initial encounter

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for T83.61XA in the official ICD-10-CM tabular list, quoted as published.

Notes without a marker are published on T83.61XA 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 T83"

• 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

T83.61XA, T83.61XD, T83.61XS

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 T83.61XA

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

Before you code T83.61XA

1. 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 →

2. T83.61XA’s title joins a condition with an associated condition or complication. Confirm each component is documented. Where the classification presumes the link through the “with” convention, only a provider statement that the conditions are unrelated defeats it. A combination code is assigned only when it fully identifies the documented conditions; a required second code for the stage, type or manifestation is still reported when the notes ask for it (Guidelines I.B.9, I.A.15).

   Guide: Combination codes →

Choose the right path

1. 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 T83.61XA. 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).

Encounter type

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

The associated condition or complication

Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).

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.

Official instructions as workflow

• Excludes2 — not part of T83.61XA(22 notes)

  Coding workflow: The conditions named in this note are not included in T83.61XA. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

  CompareT86, Z93, Z43, Z44, R50.82, G97.0

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

• Use Additional Code — after identifying T83.61XA(4 notes)

  Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with T83.61XA 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 T83.61XA with…

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

The codes most likely to be picked instead of T83.61XA — 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.

• T83.61XD— 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 T83.61XD.

  Full comparison: T83.61XA vs T83.61XD →

• T83.61XS— 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 T83.61XS.

  Full comparison: T83.61XA vs T83.61XS →

• T86— 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 failure and rejection of transplanted organs and tissue adds T86; it is not part of this code and both may be reported when both are documented.

  Full comparison: T83.61XA vs T86 →

• Z93— 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 artificial opening status adds Z93; it is not part of this code and both may be reported when both are documented.

  Full comparison: T83.61XA vs Z93 →

• Z43— 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 closure of external stoma adds Z43; it is not part of this code and both may be reported when both are documented.

  Full comparison: T83.61XA vs Z43 →

• Z44— 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 fitting and adjustment of external prosthetic device adds Z44; it is not part of this code and both may be reported when both are documented.

  Full comparison: T83.61XA vs Z44 →

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. 4 Use Additional Code instructions — report the named additional code(s) when the documentation supports them. See the Use Additional Code notes
3. 22 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 T83.61XA 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 2 Excludes1 notes across 2 chapters: T88.7 — Unspecified adverse effect of drug or medicament (via T83.-), Z97 — Presence of other devices (via T83.-).

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

Referenced by 8 Excludes2 notes across 2 chapters: T78 — Adverse effects, not elsewhere classified (via T83.-), T79 — Certain early complications of trauma, not elsewhere classified (via T83.-), T80.2 — Infections following infusion, transfusion and therapeutic injection (via T83.-), T81 — Complications of procedures, not elsewhere classified (via T83.-), T81.4 — Infection following a procedure (via T83.-), T81.59 — Other complications of foreign body accidentally left in body following procedure (via T83.-), T88 — Other complications of surgical and medical care, not elsewhere classified (via T83.-), Z96 — Presence of other functional implants (via T83.-).

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

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 186 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 3 MS-DRGs: DRG 698 (MDC 11), DRG 699 (MDC 11), DRG 700 (MDC 11).

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

Clinical classification (AHRQ CCSR):INJ034 — Complication of genitourinary device, implant or graft, 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.

T83.498A — Other mechanical complication of other prosthetic devices, implants and grafts of genital tract, initial encounter, T83.510A — Infection and inflammatory reaction due to cystostomy catheter, initial encounter, T83.511A — Infection and inflammatory reaction due to indwelling urethral catheter, initial encounter, T83.512A — Infection and inflammatory reaction due to nephrostomy catheter, initial encounter, T83.518A — Infection and inflammatory reaction due to other urinary catheter, initial encounter, T83.590A — Infection and inflammatory reaction due to implanted urinary neurostimulation device, initial encounter, T83.591A — Infection and inflammatory reaction due to implanted urinary sphincter, initial encounter, T83.592A — Infection and inflammatory reaction due to indwelling ureteral stent, initial encounter, T83.593A — Infection and inflammatory reaction due to other urinary stents, initial encounter, T83.598A — Infection and inflammatory reaction due to other prosthetic device, implant and graft in urinary system, initial encounter, T83.62XA — Infection and inflammatory reaction due to implanted testicular prosthesis, initial encounter, T83.69XA — Infection and inflammatory reaction due to other prosthetic device, implant and graft in genital tract, initial encounter, T83.712A — Erosion of implanted urethral mesh to surrounding organ or tissue, initial encounter, T83.713A — Erosion of implanted urethral bulking agent to surrounding organ or tissue, initial encounter, T83.714A — Erosion of implanted ureteral bulking agent to surrounding organ or tissue, initial encounter, T83.718A — Erosion of other implanted mesh to organ or tissue, initial encounter, T83.719A — Erosion of other prosthetic materials to surrounding organ or tissue, initial encounter, T83.722A — Exposure of implanted urethral mesh into urethra, initial encounter, T83.723A — Exposure of implanted urethral bulking agent into urethra, initial encounter, T83.724A — Exposure of implanted ureteral bulking agent into ureter, initial encounter, +165 more

Same injury, other encounter phase

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

T83.61XD — Infection and inflammatory reaction due to implanted penile prosthesis, subsequent encounterCompare T83.61XA vs T83.61XD →, T83.61XS — Infection and inflammatory reaction due to implanted penile prosthesis, sequelaCompare T83.61XA vs T83.61XS →

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Complication of genitourinary device, implant or graft, initial encounter).

T83.498A — Other mechanical complication of other prosthetic devices, implants and grafts of genital tract, initial encounter, T83.510A — Infection and inflammatory reaction due to cystostomy catheter, initial encounter, T83.511A — Infection and inflammatory reaction due to indwelling urethral catheter, initial encounter, T83.512A — Infection and inflammatory reaction due to nephrostomy catheter, initial encounter, T83.518A — Infection and inflammatory reaction due to other urinary catheter, initial encounter, T83.590A — Infection and inflammatory reaction due to implanted urinary neurostimulation device, initial encounter, T83.591A — Infection and inflammatory reaction due to implanted urinary sphincter, initial encounter, T83.592A — Infection and inflammatory reaction due to indwelling ureteral stent, initial encounter, T83.593A — Infection and inflammatory reaction due to other urinary stents, initial encounter, T83.598A — Infection and inflammatory reaction due to other prosthetic device, implant and graft in urinary system, initial encounter, T83.62XA — Infection and inflammatory reaction due to implanted testicular prosthesis, initial encounter, T83.69XA — Infection and inflammatory reaction due to other prosthetic device, implant and graft in genital tract, initial encounter, T83.711A — Erosion of implanted vaginal mesh to surrounding organ or tissue, initial encounter, T83.712A — Erosion of implanted urethral mesh to surrounding organ or tissue, initial encounter, T83.713A — Erosion of implanted urethral bulking agent to surrounding organ or tissue, initial encounter, T83.714A — Erosion of implanted ureteral bulking agent to surrounding organ or tissue, initial encounter, T83.718A — Erosion of other implanted mesh to organ or tissue, initial encounter, T83.719A — Erosion of other prosthetic materials to surrounding organ or tissue, initial encounter, T83.721A — Exposure of implanted vaginal mesh into vagina, initial encounter, T83.722A — Exposure of implanted urethral mesh into urethra, initial encounter, +61 more

Contextual Map

Every relationship of T83.61XA 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 T83.61XA with these 10 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 T83.-): “specified adverse effects of drugs and medicaments (A00-R94 and T80-T88.6, T88.8)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• Z97 — Presence of other devices[Excludes1](via T83.-): “complications of internal prosthetic devices, implants and grafts (T82-T85)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Excludes2 notes

• T78 — Adverse effects, not elsewhere classified[Excludes2](via T83.-): “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 T83.-): “complications occurring during or following medical procedures (T80-T88)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• T80.2 — Infections following infusion, transfusion and therapeutic injection[Excludes2](via T83.-): “infections specified as due to prosthetic devices, implants and grafts (T82.6-T82.7, T83.5-T83.6, T84.5-T84.7, T85.7)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• T81 — Complications of procedures, not elsewhere classified[Excludes2](via T83.-): “complication of prosthetic devices, implants and grafts (T82-T85)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• T81.4 — Infection following a procedure[Excludes2](via T83.-): “infection due to prosthetic devices, implants and grafts (T82.6-T82.7, T83.5-T83.6, T84.5-T84.7, T85.7)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• T81.59 — Other complications of foreign body accidentally left in body following procedure[Excludes2](via T83.-): “obstruction or perforation due to prosthetic devices and implants intentionally left in body (T82.0-T82.5, T83.0-T83.4, T83.7, T84.0-T84.4, T85.0-T85.6)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• T88 — Other complications of surgical and medical care, not elsewhere classified[Excludes2](via T83.-): “complications of devices, implants and grafts (T82-T85)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• Z96 — Presence of other functional implants[Excludes2](via T83.-): “complications of internal prosthetic devices, implants and grafts (T82-T85)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Clinical classification (CCSR)

• INJ034 — Complication of genitourinary device, implant or graft, 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 698 — OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC[MS-DRG]: “OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC (MDC 11)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 699 — OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC[MS-DRG]: “OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC (MDC 11)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 700 — OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC[MS-DRG]: “OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC (MDC 11)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026

MDC crossing

• MDC 11 — Diseases and Disorders of the Kidney and Urinary Tract[MDC crossing]: “Diseases and Disorders of the Kidney and Urinary Tract — 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. 3,574 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Nearest codes (40)

• T83 — Complications of genitourinary prosthetic devices, implants and grafts[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• T83.590D — Infection and inflammatory reaction due to implanted urinary neurostimulation device, subsequent encounter[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• T83.590S — Infection and inflammatory reaction due to implanted urinary neurostimulation device, sequela[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• T83.591 — Infection and inflammatory reaction due to implanted urinary sphincter[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• T83.591A — Infection and inflammatory reaction due to implanted urinary sphincter, initial encounter[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• T83.591D — Infection and inflammatory reaction due to implanted urinary sphincter, subsequent encounter[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• T83.591S — Infection and inflammatory reaction due to implanted urinary sphincter, sequela[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• T83.592 — Infection and inflammatory reaction due to indwelling ureteral stent[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• and 32 more

Change history

• FY2017 — Added to the code set[Change history]— CMS release files (code change ledger) · icd10cm-fy2017

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 T83.61XA in its code family, with their registry titles.

• T83.598A — Infection and inflammatory reaction due to other prosthetic device, implant and graft in urinary system, initial encounter
• T83.598D — Infection and inflammatory reaction due to other prosthetic device, implant and graft in urinary system, subsequent encounter
• T83.598S — Infection and inflammatory reaction due to other prosthetic device, implant and graft in urinary system, sequela
• T83.6 — Infection and inflammatory reaction due to prosthetic device, implant and graft in genital tract
• T83.61 — Infection and inflammatory reaction due to implanted penile prosthesis
• T83.61XD — Infection and inflammatory reaction due to implanted penile prosthesis, subsequent encounter
• T83.61XS — Infection and inflammatory reaction due to implanted penile prosthesis, sequela
• T83.62 — Infection and inflammatory reaction due to implanted testicular prosthesis
• T83.62XA — Infection and inflammatory reaction due to implanted testicular prosthesis, initial encounter
• T83.62XD — Infection and inflammatory reaction due to implanted testicular prosthesis, subsequent encounter

View all codes in the T83 family