T85.868A ICD-10-CM Code: Thrombosis 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
Official Tabular Instructional Notes
Sequencing, inclusion, and exclusion notes published for T85.868A 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.
- failure and rejection of transplanted organs and tissue (T86.-) Compare T85.868A vs T86 →
- any encounters with medical care for postprocedural conditions in which no complications are present, such as:
- artificial opening status (Z93.-) Compare T85.868A vs Z93 →
- closure of external stoma (Z43.-) Compare T85.868A vs Z43 →
- fitting and adjustment of external prosthetic device (Z44.-) Compare T85.868A vs Z44 →
- burns and corrosions from local applications and irradiation (T20-T32) Compare T85.868A vs T20 →
- complications of surgical procedures during pregnancy, childbirth and the puerperium (O00-O9A) Compare T85.868A vs O00 →
- mechanical complication of respirator ventilator
- poisoning and toxic effects of drugs and chemicals (T36-T65 with fifth or sixth character 1-4 or 6) Compare T85.868A vs T36 →
- postprocedural fever (R50.82) Compare T85.868A vs R50.82 →
- specified complications classified elsewhere, such as:
- cerebrospinal fluid leak from spinal puncture (G97.0) Compare T85.868A vs G97.0 →
- colostomy malfunction (K94.0-) Compare T85.868A vs K94.0 →
- disorders of fluid and electrolyte imbalance (E86-E87) Compare T85.868A vs E86 →
- functional disturbances following cardiac surgery (I97.0-I97.1) Compare T85.868A vs I97.0 →
- intraoperative and postprocedural complications of specified body systems (D78.-, E36.-, E89.-, G97.3-, G97.4, H59.3-, H59.-, H95.2-, H95.3, I97.4-, I97.5, J95.6-, J95.7, K91.6-, L76.-, M96.-, N99.-) Compare T85.868A vs D78 →
- ostomy complications (J95.0-, K94.-, N99.5-) Compare T85.868A vs J95.0 →
- postgastric surgery syndromes (K91.1) Compare T85.868A vs K91.1 →
- postlaminectomy syndrome NEC (M96.1) Compare T85.868A vs M96.1 →
- postmastectomy lymphedema syndrome (I97.2) Compare T85.868A vs I97.2 →
- postsurgical blind-loop syndrome (K91.2) Compare T85.868A vs K91.2 →
- ventilator associated pneumonia (J95.851) Compare T85.868A vs J95.851 →
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)
Change history
- FY2017 — 2016-10-01Added to the code setThrombosis due to other internal prosthetic devices, implants and grafts, initial encounterFY2017 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.
Contextual Map
Every relationship of T85.868A 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, thrombosis[Index term]
- Complication (s) (from) (of), bile duct implant (prosthetic), thrombosis[Index term]
- Complication (s) (from) (of), breast implant (prosthetic), thrombosis[Index term]
- Complication (s) (from) (of), catheter NEC (device), intraperitoneal dialysis, thrombosis[Index term]
- Complication (s) (from) (of), esophageal anti-reflux device, thrombosis[Index term]
- Complication (s) (from) (of), eye, implant (prosthetic), thrombosis[Index term]
- Complication (s) (from) (of), gastrointestinal, prosthetic device or implant, specified type NEC, thrombosis[Index term]
- Complication (s) (from) (of), intraocular lens (prosthetic), thrombosis[Index term]
- and 11 more
Nearest codes (40)
- T85 — Complications of other internal prosthetic devices, implants and grafts [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]
- T85.840A — Pain due to nervous system prosthetic devices, implants and grafts, initial encounter [Sibling]
- T85.840D — Pain due to nervous system prosthetic devices, implants and grafts, subsequent encounter [Sibling]
- T85.840S — Pain due to nervous system prosthetic devices, implants and grafts, sequela [Sibling]
- T85.848 — Pain due to other internal prosthetic devices, implants and grafts [Sibling]
- and 32 more
Change history
- FY2017 — Added to the code set [Change history]
Referenced by Other Codes
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.
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.
Official ICD-10-CM tabular notes on other codes that name T85.868A or its code family.
1 Excludes2 notes: T80.1 (via T85.8.-).
Frequently Asked Questions (FAQ) & Clinical Guidance
Does T85.868A 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 T85.868A in its code family, with their registry titles.
- 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
- T85.860D — Thrombosis due to nervous system prosthetic devices, implants and grafts, subsequent encounter
- T85.860S — Thrombosis due to nervous system prosthetic devices, implants and grafts, sequela
- T85.868 — Thrombosis due to other internal prosthetic devices, implants and grafts
- T85.868D — Thrombosis due to other internal prosthetic devices, implants and grafts, subsequent encounter
- T85.868S — Thrombosis due to other internal prosthetic devices, implants and grafts, sequela
- T85.89 — Other specified complication of internal prosthetic devices, implants and grafts, not elsewhere classified
- T85.890 — Other specified complication of nervous system prosthetic devices, implants and grafts
- T85.890A — Other specified complication of nervous system prosthetic devices, implants and grafts, initial encounter
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, thrombosis
- Complication (s) (from) (of), bile duct implant (prosthetic), thrombosis
- Complication (s) (from) (of), breast implant (prosthetic), thrombosis
- Complication (s) (from) (of), catheter NEC (device), intraperitoneal dialysis, thrombosis
- Complication (s) (from) (of), esophageal anti-reflux device, thrombosis
- Complication (s) (from) (of), eye, implant (prosthetic), thrombosis
- Complication (s) (from) (of), gastrointestinal, prosthetic device or implant, specified type NEC, thrombosis
- Complication (s) (from) (of), intraocular lens (prosthetic), thrombosis
- Complication (s) (from) (of), orbital prosthesis, thrombosis
- Complication (s) (from) (of), prosthetic device or implant, skin graft, artificial skin or decellularized allodermis, thrombosis
- Complication (s) (from) (of), prosthetic device or implant, specified NEC, thrombosis
- Complication (s) (from) (of), suture, permanent NEC (wire), thrombosis
- Thrombosis, thrombotic (bland) (multiple) (progressive) (silent) (vessel), due to device, implant or graft
- Thrombosis, thrombotic (bland) (multiple) (progressive) (silent) (vessel), due to device, implant or graft, breast (implant)
- Thrombosis, thrombotic (bland) (multiple) (progressive) (silent) (vessel), due to device, implant or graft, catheter NEC
- Thrombosis, thrombotic (bland) (multiple) (progressive) (silent) (vessel), due to device, implant or graft, catheter NEC, dialysis (renal), intraperitoneal
- Thrombosis, thrombotic (bland) (multiple) (progressive) (silent) (vessel), due to device, implant or graft, gastrointestinal (bile duct) (esophagus)
- Thrombosis, thrombotic (bland) (multiple) (progressive) (silent) (vessel), due to device, implant or graft, ocular NEC (corneal graft) (orbital implant)
- Thrombosis, thrombotic (bland) (multiple) (progressive) (silent) (vessel), due to device, implant or graft, specified NEC