2025 ICD-10-CM code T84.7
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Injury - Complications of internal orthopedic prosthetic devices, implants, or grafts Chapter 19: Injury, poisoning and certain other consequences of external causes Feed
Infection and inflammatory reaction due to other internal orthopedic prosthetic devices, implants, or grafts.
Modifiers are not applicable to ICD-10 codes. Modifiers are used with CPT and HCPCS codes to further specify circumstances of the service.
Medical necessity for treatment of an infection or inflammatory reaction related to an internal orthopedic device, implant, or graft is established by the presence of clinical symptoms (e.g., pain, swelling, redness, fever), positive cultures, imaging findings demonstrating infection or inflammation, and the need for interventions to address the complication (e.g., antibiotic therapy, surgery).
The clinical responsibility for managing an infection related to an internal orthopedic prosthetic device, implant, or graft involves identifying the infection, determining its severity, selecting appropriate antibiotics or other treatments (such as surgical intervention), monitoring the patient's response to treatment, and providing ongoing care as needed.This may involve orthopedists, infectious disease specialists, and other healthcare professionals.
- Chapter 19: Injury, poisoning and certain other consequences of external causes
- T84-T84.9: Complications of internal orthopedic prosthetic devices, implants, or grafts
In simple words: This code describes an infection or inflammation caused by something that was put inside the body during an operation, such as a joint replacement, bone plate, or other implant.It's used when the infection or inflammation is not directly related to the joint replacement or bone plate.
This ICD-10-CM code classifies infections and inflammatory reactions stemming from various internal orthopedic prosthetic devices, implants, and grafts, excluding those specifically addressed by other codes (e.g., joint prostheses, internal fixation devices).The code encompasses a broad range of post-implantation complications characterized by infectious or inflammatory processes.Appropriate additional codes should be used to specify the infecting organism and any related conditions.
Example 1: A patient with a hip replacement develops an infection at the surgical site 6 months post-operation.The infection requires hospitalization, intravenous antibiotics, and surgical debridement. Code T84.7 is used to describe the infection, along with additional codes to specify the organism causing the infection and the procedures performed., A patient with a previously implanted spinal fusion device experiences increasing back pain and localized inflammation.Imaging reveals an inflammatory reaction around the hardware, without evidence of overt infection.Code T84.7 may be used to capture the inflammatory reaction., A patient with an internal orthopedic plate fixation experiences a delayed onset of infection after a traumatic fracture. The infection requires antibiotic therapy and potential surgical revision. T84.7 is applied together with codes illustrating the specific infection and the subsequent surgical intervention.
Comprehensive documentation is required to support the use of T84.7.This includes detailed documentation of the patient's history, physical examination findings, imaging results (e.g., X-rays, CT scans, MRI), laboratory test results (e.g., complete blood count, cultures), and the course of treatment.Documentation of the specific device, implant, or graft involved is also essential.
** This code should be used cautiously and only when the infection or inflammation is not specifically attributable to a joint prosthesis or internal fixation device, for which there are more specific ICD-10 codes available within the T84 range.
- Revenue Code: Revenue codes will vary depending on the specific services provided and the payer. Consult your payer's guidelines and revenue code mapping for accurate coding.
- RVU: RVUs are not directly assigned to ICD-10 codes.Reimbursement is determined by the procedures and services performed, which are coded using CPT or HCPCS codes, and the payer's fee schedule.
- Global Days: Not applicable to ICD-10 codes.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Fee Schedule: Not applicable to ICD-10 codes.
- Specialties:Orthopedics, Infectious Disease, General Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office, Ambulatory Surgical Center