T34.60XA — Frostbite with tissue necrosis of unspecified hip and thigh, initial encounter
Is T34.60XA billable?
Yes, but T34.60XA will trip a Medicare edit. T34.60XA is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists T34.60XA under Medicare Code Editor edit 20, “Unspecified code” — meaning a code specifying laterality (right, left or bilateral) exists in the same family. On an inpatient claim this triggers the edit, because CMS holds that there are very limited circumstances in which laterality cannot be documented.
T34.60XA at a glance
| Code | T34.60XA |
|---|---|
| Description | Frostbite with tissue necrosis of unspecified hip and thigh, initial encounter |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "A" | initial encounter |
What does the 7th character "A" mean in T34.60XA?
In T34.60XA, the 7th character A means initial encounter. The 7th character is required for T34.60XA to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
What Medicare edits apply to T34.60XA?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name T34.60XA directly.
A code specifying laterality (right, left or bilateral) exists in the same family. CMS holds that there are very limited circumstances in which laterality cannot be documented.
Which MS-DRGs does T34.60XA group to?
T34.60XA sits in MDC 21 and helps define the logic of 2 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 922Other Injury, Poisoning and Toxic Effect Diagnoses with MCCmedical
- 923Other Injury, Poisoning and Toxic Effect Diagnoses without MCCmedical
As a secondary diagnosis, T34.60XA is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG. It also carries Hospital-Acquired Condition category 05.
How is T34.60XA listed in the Alphabetic Index?
The Alphabetic Index lists these routes under T34.6, the nearest indexed parent of T34.60XA. Use them to find the family, then select the specific code.
- Frostbite › hip › with tissue necrosis (superficial)
Use additional code — inherited from Chapter 19
Report an additional code alongside T34.60XA to fully describe the condition. T34.60XA is sequenced first.
- code to identify any retained foreign body, if applicable (Z18.-)
Excludes2 — not included here — inherited from Chapter 19
The conditions below are not part of T34.60XA, but a patient may have both at the same time. When documentation supports it, T34.60XA and the excluded code may both be reported.
Excludes2 — not included here — inherited from T33-T34
The conditions below are not part of T34.60XA, but a patient may have both at the same time. When documentation supports it, T34.60XA and the excluded code may both be reported.
How long has T34.60XA existed?
T34.60XA has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.