2025 ICD-10-CM code T85.61
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Injury - Mechanical complication of internal prosthetic devices, implants and grafts Injury, poisoning and certain other consequences of external causes (S00-T88) Feed
Mechanical breakdown of other specified internal prosthetic devices, implants, and grafts.
Medical necessity is established by the presence of a mechanical failure of the internal prosthetic device, implant, or graft that compromises the patient's health or functionality.The need for repair or replacement of the device is typically medically necessary to restore function and prevent further complications.
The clinical responsibility rests with the physician who manages the patient's care following the mechanical breakdown of the device. This may include orthopedic surgeons, cardiologists, urologists, or other specialists, depending on the location and type of implant.Responsibilities include diagnosis of the malfunction, assessment of its severity, patient management and monitoring, and the decision regarding further intervention, including surgical repair or replacement.
- Injury, poisoning and certain other consequences of external causes (S00-T88)
- T85.6 - Mechanical complication of internal prosthetic devices, implants and grafts, not elsewhere classified
In simple words: This code is for when a medical device implanted inside the body breaks down or malfunctions.This includes things like artificial joints or other implants, and does not include failures specifically mentioned in other codes.
This code classifies the mechanical failure of various internal prosthetic devices, implants, or grafts, excluding those specifically listed elsewhere.It encompasses complications arising from the malfunction or breakage of these medical devices within the body, requiring further investigation and potentially intervention.This code should be used when the specific type of device or implant is not further specified or is not listed under other, more specific codes within the T85 category.
Example 1: A patient with a previously implanted hip prosthesis experiences a mechanical fracture of the device resulting in pain and limited mobility. Code T85.61 is used, along with codes specifying the location and type of fracture., A patient with an implanted cardiac pacemaker experiences a mechanical malfunction leading to irregular heart rhythm. Code T85.61 is used, along with a code to specify the nature of the malfunction., A patient with an implanted intraperitoneal dialysis catheter experiences a mechanical failure leading to leakage. Code T85.61 is used in conjunction with a code for catheter failure.
Detailed documentation should include the type of prosthetic device, implant, or graft; the date of implantation; the date of failure; a description of the mechanical failure; and the clinical findings, such as pain, swelling, or functional impairment.Relevant imaging studies (x-rays, CT scans, etc.) should be documented as well as any treatment provided (e.g., surgical revision, replacement).
** This code is for mechanical complications; do not use it for failure or rejection of transplanted organs or tissues (T86.-).
- Payment Status: Active
- Specialties:Orthopedics, Cardiology, Urology, General Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center