ICDcodes.org
FY2027

T81.41 — Infection following a procedure, superficial incisional surgical site

Not billable

Is T81.41 billable?

No — T81.41 is a non-billable header code. T81.41 groups more specific codes and cannot be submitted on a claim. A valid ICD-10-CM code must be reported at the highest level of specificity available in its branch. Select one of the 3 billable codes beneath T81.41.

T81.41 at a glance

CodeT81.41
DescriptionInfection following a procedure, superficial incisional surgical site
BillableNo — header code
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027

How is T81.41 listed in the Alphabetic Index?

These are the routes through the Alphabetic Index that lead to T81.41. They show the wording a clinician may have documented, which often differs from the Tabular description.

  • Abscess › stitch (connective tissue) (embolic) (fistulous) (infective) (metastatic) (multiple) (pernicious) (pyogenic) (septic)
  • Stitch › abscess
  • Abscess › subcutaneous › following procedure (connective tissue) (embolic) (fistulous) (infective) (metastatic) (multiple) (pernicious) (pyogenic) (septic)
  • Complication › surgical procedure › stitch abscess (s) (from) (of)
  • Infection, infected, infective › postoperative wound › surgical site › superficial incisional (opportunistic)

Inclusion terms

Alternative wording in documentation that is classified to T81.41.

  • Subcutaneous abscess following a procedure
  • Stitch abscess following a procedure

Use additional code — inherited from Chapter 19

Report an additional code alongside T81.41 to fully describe the condition. T81.41 is sequenced first.

  • code to identify any retained foreign body, if applicable (Z18.-)

Use additional code — inherited from T80-T88

Report an additional code alongside T81.41 to fully describe the condition. T81.41 is sequenced first.

  • code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)
  • code(s) to identify the specified condition resulting from the complication
  • code to identify devices involved and details of circumstances (Y62-Y82)

Use additional code — inherited from T81

Report an additional code alongside T81.41 to fully describe the condition. T81.41 is sequenced first.

  • code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)

Use additional code — inherited from T81.4

Report an additional code alongside T81.41 to fully describe the condition. T81.41 is sequenced first.

  • code to identify infection
  • code (R65.2-) to identify severe sepsis, if applicable

Excludes2 — not included here — inherited from Chapter 19

The conditions below are not part of T81.41, but a patient may have both at the same time. When documentation supports it, T81.41 and the excluded code may both be reported.

  • birth trauma (P10-P15)
  • obstetric trauma (O70-O71)

Excludes2 — not included here — inherited from T80-T88

The conditions below are not part of T81.41, but a patient may have both at the same time. When documentation supports it, T81.41 and the excluded code may both be reported.

  • any encounters with medical care for postprocedural conditions in which no complications are present, such as:
  • artificial opening status (Z93.-)
  • closure of external stoma (Z43.-)
  • fitting and adjustment of external prosthetic device (Z44.-)
  • burns and corrosions from local applications and irradiation (T20-T32)
  • complications of surgical procedures during pregnancy, childbirth and the puerperium (O00-O9A)
  • mechanical complication of respirator [ventilator] (J95.850)
  • poisoning and toxic effects of drugs and chemicals (T36-T65 with fifth or sixth character 1-4 or 6)
  • postprocedural fever (R50.82)
  • specified complications classified elsewhere, such as:
  • cerebrospinal fluid leak from spinal puncture (G97.0)
  • colostomy malfunction (K94.0-)
  • disorders of fluid and electrolyte imbalance (E86-E87)
  • functional disturbances following cardiac surgery (I97.0-I97.1)
  • intraoperative and postprocedural complications of specified body systems (D78.-, E36.-, E89.-, G97.3-, G97.4, H59.3-, H59.-, H95.2-, H95.3, I97.4-, I97.5, J95.6-, J95.7, K91.6-, L76.-, M96.-, N99.-)
  • ostomy complications (J95.0-, K94.-, N99.5-)
  • postgastric surgery syndromes (K91.1)
  • postlaminectomy syndrome NEC (M96.1)
  • postmastectomy lymphedema syndrome (I97.2)
  • postsurgical blind-loop syndrome (K91.2)
  • ventilator associated pneumonia (J95.851)

Excludes2 — not included here — inherited from T81

The conditions below are not part of T81.41, but a patient may have both at the same time. When documentation supports it, T81.41 and the excluded code may both be reported.

  • complications following immunization (T88.0-T88.1)
  • complications following infusion, transfusion and therapeutic injection (T80.-)
  • complications of transplanted organs and tissue (T86.-)
  • specified complications classified elsewhere, such as:
  • complication of prosthetic devices, implants and grafts (T82-T85)
  • dermatitis due to drugs and medicaments (L23.3, L24.4, L25.1, L27.0-L27.1)
  • endosseous dental implant failure (M27.6-)
  • floppy iris syndrome (IFIS) (intraoperative) H21.81
  • intraoperative and postprocedural complications of specific body system (D78.-, E36.-, E89.-, G97.3-, G97.4, H59.3-, H59.-, H95.2-, H95.3, I97.4-, I97.5, J95, K91.-, L76.-, M96.-, N99.-)
  • ostomy complications (J95.0-, K94.-, N99.5-)
  • plateau iris syndrome (post-iridectomy) (postprocedural) H21.82
  • poisoning and toxic effects of drugs and chemicals (T36-T65 with fifth or sixth character 1-4)

Excludes2 — not included here — inherited from T81.4

The conditions below are not part of T81.41, but a patient may have both at the same time. When documentation supports it, T81.41 and the excluded code may both be reported.

  • bleb associated endophthalmitis (H59.4-)
  • infection due to infusion, transfusion and therapeutic injection (T80.2-)
  • infection due to prosthetic devices, implants and grafts (T82.6-T82.7, T83.5-T83.6, T84.5-T84.7, T85.7)
  • obstetric surgical wound infection (O86.0-)
  • postprocedural fever NOS (R50.82)
  • postprocedural retroperitoneal abscess (K68.11)

Code also — inherited from T81.4

Two codes may be needed to describe the condition fully. Whether T81.41 is sequenced first depends on the reason for the encounter.

  • , if applicable, disruption of internal operation (surgical) wound (T81.32-)

What codes fall under T81.41? (3)

How long has T81.41 existed?

T81.41 first appears in FY2019.

Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.

What other codes are in the T81.4 family? (5)