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

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 922 — OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC (MDC 21)
  • MS-DRG 923 — OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT 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

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

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for T85.21XS 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 T85.21XS 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 T85.21XS 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)

  • INJ076 — Complication, sequela [CCSR]

Potential MS-DRG

  • DRG 922 — OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC [MS-DRG]: “OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC (MDC 21)”
  • DRG 923 — OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC [MS-DRG]: “OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC (MDC 21)”

MDC crossing · procedures (32029)

  • 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.”
  • 0016070 — Bypass Cerebral Ventricle to Nasopharynx with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Nasopharynx with Autologous Tissue Substitute, Open Approach — grouped in MDC 21, the procedure side of this code's crossing.” · check together
  • 0016071 — Bypass Cerebral Ventricle to Mastoid Sinus with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Mastoid Sinus with Autologous Tissue Substitute, Open Approach — grouped in MDC 21, the procedure side of this code's crossing.” · check together
  • 0016072 — Bypass Cerebral Ventricle to Atrium with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Atrium with Autologous Tissue Substitute, Open Approach — grouped in MDC 21, the procedure side of this code's crossing.” · check together
  • 0016073 — Bypass Cerebral Ventricle to Blood Vessel with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Blood Vessel with Autologous Tissue Substitute, Open Approach — grouped in MDC 21, the procedure side of this code's crossing.” · check together
  • 0016074 — Bypass Cerebral Ventricle to Pleural Cavity with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Pleural Cavity with Autologous Tissue Substitute, Open Approach — grouped in MDC 21, the procedure side of this code's crossing.” · check together
  • and 32024 more

Nearest codes (40)

  • T85 — Complications of other internal prosthetic devices, implants and grafts [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]
  • T85.192D — Other mechanical complication of implanted electronic neurostimulator of spinal cord electrode (lead), subsequent encounter [Sibling]
  • and 32 more

Relationships & Classification

Clinical classification (AHRQ CCSR):INJ076 — Complication, sequela (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 922 (MDC 21), DRG 923 (MDC 21).

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 T85.21XS 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 T85.21XS in its code family, with their registry titles.

  • 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
  • T85.21XD — Breakdown (mechanical) of intraocular lens, subsequent encounter
  • 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
  • T85.29 — Other mechanical complication of intraocular lens

View all codes in the T85 family