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T85.21XD ICD-10-CM Code: Breakdown (mechanical) of intraocular lens, subsequent 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.

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

Breakdown (mechanical) of intraocular lens, subsequent encounter is a billable ICD-10-CM diagnosis code (T85.21D).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for T85.21XD 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 T85.21XD 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

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

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

Contextual Map

Every relationship of T85.21XD 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]

Clinical classification (CCSR)

  • INJ072 — Complication of other surgical or medical care, injury, subsequent encounter [CCSR]

Potential MS-DRG

  • DRG 949 — AFTERCARE WITH CC/MCC [MS-DRG]: “AFTERCARE WITH CC/MCC (MDC 23)”
  • DRG 950 — AFTERCARE WITHOUT CC/MCC [MS-DRG]: “AFTERCARE WITHOUT CC/MCC (MDC 23)”

MDC crossing · procedures (1235)

  • MDC 23 — Factors Influencing Health Status and Other Contacts with Health Services [MDC crossing]: “Factors Influencing Health Status and Other Contacts with Health Services — 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.”
  • F003GKZ — Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body using Audiovisual Equipment [Same-MDC procedure]: “Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body using Audiovisual Equipment — grouped in MDC 23, the procedure side of this code's crossing.” · check together
  • F003GMZ — Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body using Augmentative / Alternative Communication Equipment [Same-MDC procedure]: “Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body using Augmentative / Alternative Communication Equipment — grouped in MDC 23, the procedure side of this code's crossing.” · check together
  • F003GPZ — Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body using Computer [Same-MDC procedure]: “Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body using Computer — grouped in MDC 23, the procedure side of this code's crossing.” · check together
  • F003GYZ — Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body using Other Equipment [Same-MDC procedure]: “Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body using Other Equipment — grouped in MDC 23, the procedure side of this code's crossing.” · check together
  • F003GZZ — Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body [Same-MDC procedure]: “Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body — grouped in MDC 23, the procedure side of this code's crossing.” · check together
  • and 1230 more

Nearest codes (40)

  • T85 — Complications of other internal prosthetic devices, implants and grafts [Sibling]
  • T85.190S — Other mechanical complication of implanted electronic neurostimulator of brain electrode (lead), sequela [Sibling]
  • T85.191 — Other mechanical complication of implanted electronic neurostimulator of peripheral nerve electrode (lead) [Sibling]
  • T85.191A — Other mechanical complication of implanted electronic neurostimulator of peripheral nerve electrode (lead), initial encounter [Sibling]
  • T85.191D — Other mechanical complication of implanted electronic neurostimulator of peripheral nerve electrode (lead), subsequent encounter [Sibling]
  • T85.191S — Other mechanical complication of implanted electronic neurostimulator of peripheral nerve electrode (lead), sequela [Sibling]
  • T85.192 — Other mechanical complication of implanted electronic neurostimulator of spinal cord electrode (lead) [Sibling]
  • T85.192A — Other mechanical complication of implanted electronic neurostimulator of spinal cord electrode (lead), initial encounter [Sibling]
  • and 32 more

Relationships & Classification

Clinical classification (AHRQ CCSR):INJ072 — Complication of other surgical or medical care, injury, subsequent encounter (default).

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

Potential MS-DRG Relationships (FY2026)

Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.

Named in the grouper logic of 2 MS-DRGs: DRG 949 (MDC 23), DRG 950 (MDC 23).

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

Frequently Asked Questions (FAQ) & Clinical Guidance

Does T85.21XD require a 7th character?

Yes. The appropriate 7th character is to be added to each code from category T85.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to T85.21XD in its code family, with their registry titles.

  • T85.199D — Other mechanical complication of other implanted electronic stimulator of nervous system, subsequent encounter
  • T85.199S — Other mechanical complication of other implanted electronic stimulator of nervous system, sequela
  • T85.2 — Mechanical complication of intraocular lens
  • T85.21 — Breakdown (mechanical) of intraocular lens
  • T85.21XA — Breakdown (mechanical) of intraocular lens, initial encounter
  • T85.21XS — Breakdown (mechanical) of intraocular lens, sequela
  • T85.22 — Displacement of intraocular lens
  • T85.22XA — Displacement of intraocular lens, initial encounter
  • T85.22XD — Displacement of intraocular lens, subsequent encounter
  • T85.22XS — Displacement of intraocular lens, sequela

View all codes in the T85 family