2025 ICD-10-CM code T84.84
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Injury - Other complications of internal orthopedic prosthetic devices, implants and grafts Chapter 19: Injury, poisoning and certain other consequences of external causes Feed
Pain due to internal orthopedic prosthetic devices, implants, or grafts.
Modifiers may be applicable depending on the circumstances of the encounter and the services provided. Consult the official guidelines for modifier usage.
The medical necessity for coding T84.84 is established when the pain is directly attributed to the presence of the internal orthopedic prosthetic device, implant or graft.The pain must significantly impair the patient's function or quality of life and be unresponsive to conservative management.This warrants further investigation and treatment of the pain.
Orthopedic surgeon, pain management specialist
- Chapter 19: Injury, poisoning and certain other consequences of external causes
- T84-T88: Complications of surgical and medical care, not elsewhere classified
In simple words: This code describes pain caused by something put inside the body as part of an orthopedic operation, such as a joint replacement or bone plate.This code specifically refers to pain, not other problems with the implant.
This code is used to classify pain resulting from internal orthopedic prosthetic devices, implants, or grafts.It encompasses pain experienced as a direct consequence of the presence of these medical devices, excluding other complications such as infection or mechanical failure, which have their own specific codes.The pain may be localized to the site of the implant or may be referred pain. The etiology of the pain can be diverse and may require further investigation.
Example 1: A 65-year-old patient presents with persistent pain in their right hip six months after a total hip arthroplasty.Imaging studies reveal no signs of loosening or dislocation of the prosthesis, and the patient's pain is attributed to the implant itself. Code T84.84 is applied., A 72-year-old patient reports chronic pain in their left knee two years after undergoing a total knee replacement.The pain is localized to the area around the prosthetic knee joint, andphysical examination and radiographic findings do not reveal any other musculoskeletal problems.Code T84.84 is used., A 40-year-old patient complains of persistent pain at the site of an internal spinal fixation device placed after a vertebral fracture sustained in a motor vehicle accident three years prior. The patient states that the pain is exacerbated by physical activity. Code T84.84 is used.
Detailed history of the implant placement including date, type of implant, and surgical procedure.Clinical findings such as physical examination findings noting location, character, and intensity of the pain. Results of imaging studies (X-rays, CT scans, MRI) to rule out other causes of pain (e.g. fracture, infection, loosening of the implant). Documentation of any treatment provided for the pain.
** This code should only be used when the pain is the primary issue and not secondary to other complications associated with the implant.Careful consideration should be given to other relevant codes to accurately reflect the patient's clinical picture.
- Payment Status: Active
- Specialties:Orthopedics, Pain Management
- Place of Service:Office, Hospital Inpatient, Hospital Outpatient, Ambulatory Surgical Center