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T85.858A ICD-10-CM Code: Stenosis due to other internal prosthetic devices, implants and grafts, 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 919 — COMPLICATIONS OF TREATMENT WITH MCC (MDC 21)
  • MS-DRG 920 — COMPLICATIONS OF TREATMENT WITH CC (MDC 21)
  • MS-DRG 921 — COMPLICATIONS OF TREATMENT WITHOUT CC/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

Stenosis due to other internal prosthetic devices, implants and grafts, initial encounter is a billable ICD-10-CM diagnosis code (T85.858A).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for T85.858A 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)

Indexed Clinical Terms (19)

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

  • Complication (s) (from) (of), balloon implant or device, gastrointestinal, stenosis
  • Complication (s) (from) (of), bile duct implant (prosthetic), stenosis
  • Complication (s) (from) (of), breast implant (prosthetic), stenosis
  • Complication (s) (from) (of), catheter NEC (device), intraperitoneal dialysis, stenosis
  • Complication (s) (from) (of), esophageal anti-reflux device, stenosis
  • Complication (s) (from) (of), eye, implant (prosthetic), stenosis
  • Complication (s) (from) (of), gastrointestinal, prosthetic device or implant, specified type NEC, stenosis
  • Complication (s) (from) (of), intraocular lens (prosthetic), stenosis
  • Complication (s) (from) (of), orbital prosthesis, stenosis
  • Complication (s) (from) (of), prosthetic device or implant, skin graft, artificial skin or decellularized allodermis, stenosis
  • Complication (s) (from) (of), prosthetic device or implant, specified NEC, stenosis
  • Complication (s) (from) (of), suture, permanent NEC (wire), stenosis
  • Stenosis, stenotic (cicatricial), due to presence of device, implant or graft
  • Stenosis, stenotic (cicatricial), due to presence of device, implant or graft, breast (implant)
  • Stenosis, stenotic (cicatricial), due to presence of device, implant or graft, catheter
  • Stenosis, stenotic (cicatricial), due to presence of device, implant or graft, catheter, dialysis (renal), intraperitoneal
  • Stenosis, stenotic (cicatricial), due to presence of device, implant or graft, gastrointestinal (bile duct) (esophagus)
  • Stenosis, stenotic (cicatricial), due to presence of device, implant or graft, ocular NEC (corneal graft) (orbital implant)
  • Stenosis, stenotic (cicatricial), due to presence of device, implant or graft, specified NEC

Frequently Compared Codes

The official Excludes notes on T85.858A name these codes. Each comparison page covers when the two can — or must not — be reported together.

Change history

  • FY2017 — 2016-10-01
    Added to the code set
    Stenosis due to other internal prosthetic devices, implants and grafts, initial encounter
    FY2017 changes

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.

Relationships & Classification

Official ICD-10-CM tabular notes on other codes that name T85.858A or its code family.

1 Excludes2 notes: T80.1 (via T85.8.-).

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 3 MS-DRGs: DRG 919 (MDC 21), DRG 920 (MDC 21), DRG 921 (MDC 21).

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

Clinical classification (AHRQ CCSR):INJ037 — Complication of other surgical or medical care, injury, 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 T85.858A 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

  • T80.1 — Vascular complications following infusion, transfusion and therapeutic injection [Excludes2](via T85.8.-): “vascular complications specified as due to prosthetic devices, implants and grafts (T82.8-, T83.8-, T84.8-, T85.8-)” · check together

Clinical classification (CCSR)

  • INJ037 — Complication of other surgical or medical care, injury, initial encounter [CCSR]

Potential MS-DRG

  • DRG 919 — COMPLICATIONS OF TREATMENT WITH MCC [MS-DRG]: “COMPLICATIONS OF TREATMENT WITH MCC (MDC 21)”
  • DRG 920 — COMPLICATIONS OF TREATMENT WITH CC [MS-DRG]: “COMPLICATIONS OF TREATMENT WITH CC (MDC 21)”
  • DRG 921 — COMPLICATIONS OF TREATMENT WITHOUT CC/MCC [MS-DRG]: “COMPLICATIONS OF TREATMENT WITHOUT CC/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

Index entries (19)

  • Complication (s) (from) (of), balloon implant or device, gastrointestinal, stenosis[Index term]
  • Complication (s) (from) (of), bile duct implant (prosthetic), stenosis[Index term]
  • Complication (s) (from) (of), breast implant (prosthetic), stenosis[Index term]
  • Complication (s) (from) (of), catheter NEC (device), intraperitoneal dialysis, stenosis[Index term]
  • Complication (s) (from) (of), esophageal anti-reflux device, stenosis[Index term]
  • Complication (s) (from) (of), eye, implant (prosthetic), stenosis[Index term]
  • Complication (s) (from) (of), gastrointestinal, prosthetic device or implant, specified type NEC, stenosis[Index term]
  • Complication (s) (from) (of), intraocular lens (prosthetic), stenosis[Index term]
  • and 11 more

Nearest codes (40)

  • T85 — Complications of other internal prosthetic devices, implants and grafts [Sibling]
  • T85.830S — Hemorrhage due to nervous system prosthetic devices, implants and grafts, sequela [Sibling]
  • T85.838 — Hemorrhage due to other internal prosthetic devices, implants and grafts [Sibling]
  • T85.838A — Hemorrhage due to other internal prosthetic devices, implants and grafts, initial encounter [Sibling]
  • T85.838D — Hemorrhage due to other internal prosthetic devices, implants and grafts, subsequent encounter [Sibling]
  • T85.838S — Hemorrhage due to other internal prosthetic devices, implants and grafts, sequela [Sibling]
  • T85.84 — Pain due to internal prosthetic devices, implants and grafts, not elsewhere classified [Sibling]
  • T85.840 — Pain due to nervous system prosthetic devices, implants and grafts [Sibling]
  • and 32 more

Change history

  • FY2017 — Added to the code set [Change history]

Frequently Asked Questions (FAQ) & Clinical Guidance

Does T85.858A 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 T85.858A in its code family, with their registry titles.

  • T85.850 — Stenosis due to nervous system prosthetic devices, implants and grafts
  • T85.850A — Stenosis due to nervous system prosthetic devices, implants and grafts, initial encounter
  • T85.850D — Stenosis due to nervous system prosthetic devices, implants and grafts, subsequent encounter
  • T85.850S — Stenosis due to nervous system prosthetic devices, implants and grafts, sequela
  • T85.858 — Stenosis due to other internal prosthetic devices, implants and grafts
  • T85.858D — Stenosis due to other internal prosthetic devices, implants and grafts, subsequent encounter
  • T85.858S — Stenosis due to other internal prosthetic devices, implants and grafts, sequela
  • T85.86 — Thrombosis due to internal prosthetic devices, implants and grafts, not elsewhere classified
  • T85.860 — Thrombosis due to nervous system prosthetic devices, implants and grafts
  • T85.860A — Thrombosis due to nervous system prosthetic devices, implants and grafts, initial encounter

View all codes in the T85 family