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ICD-10/T85.72

T85.72 ICD-10-CM Code: Infection and inflammatory reaction due to insulin pump

Billing Status: NO. This is a clinician non-billable / parent hierarchy grouping in the ICD-10-CM system.

Official Registry Overview & Definition

Infection and inflammatory reaction due to insulin pump is a non-billable ICD-10-CM category code (T85.72). A more specific billable subcode must be selected for claims submission.

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for T85.72 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 to identify infection
  • 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)

Change history

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

Verify Before Coding

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 T85.72 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]

Index entries

  • Complication (s) (from) (of), insulin pump, infection and inflammation[Index term]

Nearest codes (40)

  • T85 — Complications of other internal prosthetic devices, implants and grafts [Sibling]
  • T85.693A — Other mechanical complication of artificial skin graft and decellularized allodermis, initial encounter [Sibling]
  • T85.693D — Other mechanical complication of artificial skin graft and decellularized allodermis, subsequent encounter [Sibling]
  • T85.693S — Other mechanical complication of artificial skin graft and decellularized allodermis, sequela [Sibling]
  • T85.694 — Other mechanical complication of insulin pump [Sibling]
  • T85.694A — Other mechanical complication of insulin pump, initial encounter [Sibling]
  • T85.694D — Other mechanical complication of insulin pump, subsequent encounter [Sibling]
  • T85.694S — Other mechanical complication of insulin pump, sequela [Sibling]
  • and 32 more

Frequently Asked Questions (FAQ) & Clinical Guidance

Can T85.72 be billed directly?

No. T85.72 (Infection and inflammatory reaction due to insulin pump) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.

Does T85.72 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 T85.72 in its code family, with their registry titles.

  • T85.7 — Infection and inflammatory reaction due to other internal prosthetic devices, implants and grafts
  • T85.71 — Infection and inflammatory reaction due to peritoneal dialysis catheter
  • T85.71XA — Infection and inflammatory reaction due to peritoneal dialysis catheter, initial encounter
  • T85.71XD — Infection and inflammatory reaction due to peritoneal dialysis catheter, subsequent encounter
  • T85.71XS — Infection and inflammatory reaction due to peritoneal dialysis catheter, sequela
  • T85.72XA — Infection and inflammatory reaction due to insulin pump, initial encounter
  • T85.72XD — Infection and inflammatory reaction due to insulin pump, subsequent encounter
  • T85.72XS — Infection and inflammatory reaction due to insulin pump, sequela
  • T85.73 — Infection and inflammatory reaction due to nervous system devices, implants and graft
  • T85.730 — Infection and inflammatory reaction due to ventricular intracranial (communicating) shunt

View all codes in the T85 family

Indexed Clinical Terms (1)

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code.

  • Complication (s) (from) (of), insulin pump, infection and inflammation