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T84.9XXA ICD-10-CM Code: Unspecified complication of internal orthopedic prosthetic device, implant and graft, 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 559 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC (MDC 08)
  • MS-DRG 560 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC (MDC 08)
  • MS-DRG 561 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC (MDC 08)

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

Unspecified complication of internal orthopedic prosthetic device, implant and graft, initial encounter is a billable ICD-10-CM diagnosis code (T84.9A).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for T84.9XXA 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.

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • 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 T84.9XXA 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 T84.9XXA or its code family.

2 Excludes2 notes: M96 (via T84.-), M96.6 (via T84.-).

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 262 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 3 MS-DRGs: DRG 559 (MDC 08), DRG 560 (MDC 08), DRG 561 (MDC 08).

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

Clinical classification (AHRQ CCSR):INJ035 — Complication of internal orthopedic device or implant, 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 T84.9XXA 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

  • M96 — Intraoperative and postprocedural complications and disorders of musculoskeletal system, not elsewhere classified [Excludes2](via T84.-): “complications of internal orthopedic prosthetic devices, implants and grafts (T84.-)” · check together
  • M96.6 — Fracture of bone following insertion of orthopedic implant, joint prosthesis, or bone plate [Excludes2](via T84.-): “complication of internal orthopedic devices, implants or grafts (T84.-)” · check together

Clinical classification (CCSR)

  • INJ035 — Complication of internal orthopedic device or implant, 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 559 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC [MS-DRG]: “AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC (MDC 08)”
  • DRG 560 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC [MS-DRG]: “AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC (MDC 08)”
  • DRG 561 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC [MS-DRG]: “AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC (MDC 08)”

MDC crossing · procedures (18508)

  • MDC 08 — Diseases and Disorders of the Musculoskeletal System and Connective Tissue [MDC crossing]: “Diseases and Disorders of the Musculoskeletal System and Connective Tissue — 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.”
  • 005T0ZZ — Destruction of Spinal Meninges, Open Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005T3ZZ — Destruction of Spinal Meninges, Percutaneous Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Percutaneous Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005T4ZZ — Destruction of Spinal Meninges, Percutaneous Endoscopic Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Percutaneous Endoscopic Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005W0Z3 — Destruction of Cervical Spinal Cord using Laser Interstitial Thermal Therapy, Open Approach [Same-MDC procedure]: “Destruction of Cervical Spinal Cord using Laser Interstitial Thermal Therapy, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005W0ZZ — Destruction of Cervical Spinal Cord, Open Approach [Same-MDC procedure]: “Destruction of Cervical Spinal Cord, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • and 18503 more

Nearest codes (40)

  • T84 — Complications of internal orthopedic prosthetic devices, implants and grafts [Sibling]
  • T84.69 — Infection and inflammatory reaction due to internal fixation device of other site [Sibling]
  • T84.69XA — Infection and inflammatory reaction due to internal fixation device of other site, initial encounter [Sibling]
  • T84.69XD — Infection and inflammatory reaction due to internal fixation device of other site, subsequent encounter [Sibling]
  • T84.69XS — Infection and inflammatory reaction due to internal fixation device of other site, sequela [Sibling]
  • T84.7 — Infection and inflammatory reaction due to other internal orthopedic prosthetic devices, implants and grafts [Sibling]
  • T84.7XXA — Infection and inflammatory reaction due to other internal orthopedic prosthetic devices, implants and grafts, initial encounter [Sibling]
  • T84.7XXD — Infection and inflammatory reaction due to other internal orthopedic prosthetic devices, implants and grafts, subsequent encounter [Sibling]
  • and 32 more

Frequently Asked Questions (FAQ) & Clinical Guidance

Does T84.9XXA require a 7th character?

Yes. The appropriate 7th character is to be added to each code from category T84.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to T84.9XXA in its code family, with their registry titles.

  • T84.86 — Thrombosis due to internal orthopedic prosthetic devices, implants and grafts
  • T84.86XA — Thrombosis due to internal orthopedic prosthetic devices, implants and grafts, initial encounter
  • T84.86XD — Thrombosis due to internal orthopedic prosthetic devices, implants and grafts, subsequent encounter
  • T84.86XS — Thrombosis due to internal orthopedic prosthetic devices, implants and grafts, sequela
  • T84.89 — Other specified complication of internal orthopedic prosthetic devices, implants and grafts
  • T84.89XA — Other specified complication of internal orthopedic prosthetic devices, implants and grafts, initial encounter
  • T84.89XD — Other specified complication of internal orthopedic prosthetic devices, implants and grafts, subsequent encounter
  • T84.89XS — Other specified complication of internal orthopedic prosthetic devices, implants and grafts, sequela
  • T84.9 — Unspecified complication of internal orthopedic prosthetic device, implant and graft
  • T84.9XXD — Unspecified complication of internal orthopedic prosthetic device, implant and graft, subsequent encounter

View all codes in the T84 family