2025 ICD-10-CM code T83.85XA
(Active) Effective Date: N/A Revision Date: N/A Injury - Complications of genitourinary prosthetic devices, implants and grafts Injury, poisoning and certain other consequences of external causes (S00-T88) Feed
Stenosis due to genitourinary prosthetic devices, implants, or grafts, initial encounter.
Modifiers may be necessary depending on the circumstances. Consult the NCCI edits and payer-specific guidelines.
Medical necessity for coding T83.85XA is established by the presence of clinically significant stenosis related to the implanted genitourinary device or graft.Symptoms must warrant medical intervention, such as treatment or surgical repair of the stricture.Diagnostic imaging or other objective evidence must confirm the presence and severity of the stenosis.
The clinical responsibility lies with the physician or surgeon managing the patient's genitourinary condition and the complication related to the implanted device or graft. This would encompass diagnosis, treatment, and follow-up care. Specialists such as urologists or gynecologists may be primarily responsible, depending on the specific location and nature of the stenosis.
- Injury, poisoning and certain other consequences of external causes (S00-T88)
- T83.85XA falls under the broader category of complications due to genitourinary prosthetic devices, implants, and grafts within the ICD-10-CM Chapter on injuries, poisonings, and other consequences of external causes.
In simple words: This code is used when a patient experiences narrowing (stenosis) in their urinary or reproductive system due to a problem with an implanted device or graft. This is used only for the first time this problem is seen.
This code classifies the initial encounter for stenosis (narrowing) resulting from complications related to genitourinary prosthetic devices, implants, or grafts.It specifically addresses the complication of stenosis arising from these medical interventions in the genitourinary system.The code should be used when the stenosis is directly attributable to the prosthetic device, implant, or graft, and this is the first time this complication is encountered.
Example 1: A 65-year-old male patient presents with symptoms of urinary obstruction three months after undergoing a transurethral resection of the prostate (TURP) with urethral stent placement. Imaging reveals urethral stricture at the site of the stent.Code T83.85XA is used to report the initial encounter for this complication., A 48-year-old female patient develops dysmenorrhea and pelvic pain one year after undergoing a laparoscopic hysterectomy with mesh repair for pelvic organ prolapse.Diagnostic imaging shows mesh-related stenosis of the vaginal canal.Code T83.85XA is applied for the initial diagnosis and management of the complication., A 72-year-old male patient complains of intermittent hematuria six months post-implantation of a penile prosthesis. Cystoscopy reveals a urethral stricture secondary to the implanted device. Code T83.85XA is used to document this initial encounter of a stenosis.
Complete medical history detailing the genitourinary procedure, including dates and types of devices or grafts used.Detailed documentation of symptoms, clinical findings (e.g., physical exam, imaging studies), and diagnostic tests confirming the stenosis are crucial.Progress notes should also indicate the treatment plan for managing the stenosis.
** Accurate coding requires careful consideration of the relationship between the stenosis and the implanted device or graft.Documentation must clearly link the complication to the medical intervention to ensure appropriate reimbursement.
- Payment Status: Active
- Modifier TC rule: Not applicable. This is a diagnosis code, not a procedure code.
- Specialties:Urology, Gynecology, General Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office