2025 ICD-10-CM code T85.3
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Injury - Mechanical complication of other ocular prosthetic devices, implants and grafts Chapter 19: Injury, poisoning and certain other consequences of external causes (S00-T88) Feed
Mechanical complication of other ocular prosthetic devices, implants, and grafts.
Modifiers may be applicable depending on the circumstances of the procedure (e.g., 50 for bilateral procedures, 59 for distinct procedural services).
Medical necessity would be supported by clinical documentation demonstrating the mechanical complication of the ocular prosthetic device is causing significant visual impairment or discomfort necessitating intervention.
Ophthalmologist or other qualified eye care professional
In simple words: This code is used when there's a problem with an artificial part of the eye (like an implant or graft) due to a mechanical issue, not because the body rejected it.
This code classifies mechanical complications arising from ocular prosthetic devices, implants, or grafts, excluding other complications of corneal grafts (T86.84-).
Example 1: A patient experiences a malfunction of an intraocular lens implant, requiring surgical revision., A patient with a corneal graft develops a mechanical complication necessitating removal or replacement of the graft., Postoperative assessment reveals a dislocated or fractured artificial eye component needing surgical intervention.
* Detailed operative report outlining the procedure and any complications.* Pre-operative and post-operative imaging studies (e.g., OCT, ultrasound) demonstrating the mechanical issue.* Documentation of any symptoms, such as pain, vision changes, or inflammation.* Patient history, including details about the implant or graft.
** This code is specific to mechanical complications and excludes those related to rejection or failure of the implant or graft.
- Payment Status: Active
- Modifier TC rule: The application of a technical component (TC) modifier would depend on the specific services performed. If the physician only performs the professional component (PC) the TC modifier is not needed.
- Specialties:Ophthalmology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center, Office