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2025 ICD-10-CM code T83.85XD

Stenosis due to genitourinary prosthetic devices, implants, or grafts, subsequent encounter.

Adhere to the official ICD-10-CM coding guidelines.Ensure the proper use of 7th character codes to indicate the encounter type (A=initial, D=subsequent, S=sequela). Use additional codes to specify the cause of injury (Chapter 20), retained foreign bodies (Z18.-), and any adverse effects.Consult the official ICD-10-CM manual and any payer-specific guidelines.

Modifiers may be applicable depending on the circumstances of the visit and services provided. Consult the NCCI edits and payer guidelines for specific modifier requirements.

Medical necessity for coding T83.85XD is established when the patient presents with symptoms and objective findings consistent with stenosis (narrowing) directly attributable to the previously implanted genitourinary prosthetic device, implant, or graft.This requires appropriate documentation, as described above, linking the stenosis to the device and supporting the need for medical intervention or follow-up care.Justification should demonstrate the clinical significance and the need for treatment.

The clinical responsibility falls upon the physician or healthcare professional managing the patient's post-procedural complications. This includes monitoring the patient's condition, diagnosing any complications, and implementing appropriate management strategies to address the stenosis and its associated symptoms.The provider should also document the medical necessity of the treatment.

IMPORTANT:Related codes include T83.85XA (initial encounter) and T83.85XS (sequela).Additional codes may be necessary to specify the device involved, the circumstances of the injury, and any adverse effects or retained foreign bodies.Consider using codes from Chapter 20 (External causes of morbidity) to indicate the cause of the stenosis.

In simple words: This code is used for a follow-up visit for a narrowing of a tube or passageway in the urinary or genital system that happened because of an artificial device, implant, or graft that was put in during a previous medical procedure. This isn't used for the first visit related to this problem, only for later checkups.

This code signifies a subsequent encounter for stenosis (narrowing) resulting from genitourinary prosthetic devices, implants, or grafts.It indicates a complication arising after the initial placement or procedure.This code should only be used for subsequent encounters related to this specific complication; initial encounters should use the appropriate initial encounter code (T83.85XA).The code excludes failure or rejection of transplanted organs and tissues (T86.-).

Example 1: A patient presents with symptoms of urinary obstruction three months after a urethral stent placement.Imaging confirms stenosis at the stent site.T83.85XD is used to code the subsequent encounter for managing the complication., A patient undergoes a follow-up appointment six weeks after a bladder augmentation procedure involving a mesh implant.The patient reports worsening urinary symptoms, and cystoscopy reveals stenosis near the implant site. T83.85XD is coded for this subsequent encounter., A patient with a history of a penile implant experiences increasing difficulty with urination.Urological evaluation reveals implant-related urethral stricture. The code T83.85XD is appropriate for this subsequent visit to address the complication.

Complete documentation should include the patient's medical history, details of the initial genitourinary procedure (including the type of prosthetic device, implant, or graft used), the date of the initial procedure, a detailed description of the current symptoms, and results of any diagnostic tests (e.g., imaging studies, cystoscopy) confirming the stenosis.Progress notes should reflect the clinical findings, the plan of care, and any interventions performed to treat the stenosis.Documentation should also support medical necessity.

** Always refer to the most current version of the ICD-10-CM coding manual for the most up-to-date information and guidelines.Be sure to properly document the medical necessity for the visit and the services rendered.

  • Payment Status: Active
  • Modifier TC rule: A Technical Component (TC) modifier may or may not be applicable, depending on whether the services are primarily technical or professional.Determine applicability based on the specific services rendered and the payer's requirements.
  • Specialties:Urology, Gynecology
  • Place of Service:Office, Hospital (Inpatient or Outpatient), Ambulatory Surgical Center
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