T84.619A — Infection and inflammatory reaction due to internal fixation device of unspecified bone of arm, initial encounter

BillableUnspecifiedCC

Is T84.619A billable?

Yes, but T84.619A will trip a Medicare edit. T84.619A is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists T84.619A 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.

More specific alternatives

T84.619A at a glance

Code	T84.619A
Description	Infection and inflammatory reaction due to internal fixation device of unspecified bone of arm, 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 T84.619A?

In T84.619A, the 7th character A means initial encounter. The 7th character is required for T84.619A to be a valid, complete code.

Same condition, different episode of care — switch the 7th character:

What Medicare edits apply to T84.619A?

The Medicare Code Editor screens inpatient claims before they are grouped. These edits name T84.619A directly.

Unspecified — a laterality-specific code exists — MCE edit 20

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 T84.619A group to?

T84.619A sits in MDC 08 and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.

559Aftercare, Musculoskeletal System and Connective Tissue with MCCmedical
560Aftercare, Musculoskeletal System and Connective Tissue with CCmedical
561Aftercare, Musculoskeletal System and Connective Tissue without CC/MCCmedical

As a secondary diagnosis, T84.619A is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG. It also carries Hospital-Acquired Condition category 12.

How is T84.619A listed in the Alphabetic Index?

The Alphabetic Index lists these routes under T84.61, the nearest indexed parent of T84.619A. Use them to find the family, then select the specific code.

Complication › fixation device, internal › infection and inflammation › arm (s) (from) (of)
Complication › fixation device, internal › infection and inflammation › arm › humerus (s) (from) (of)
Complication › fixation device, internal › infection and inflammation › arm › radius (s) (from) (of)
Complication › fixation device, internal › infection and inflammation › arm › ulna (s) (from) (of)

Use additional code — inherited from Chapter 19

Report an additional code alongside T84.619A to fully describe the condition. T84.619A 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 T84.619A to fully describe the condition. T84.619A 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 T84.6

Report an additional code alongside T84.619A to fully describe the condition. T84.619A is sequenced first.

code to identify infection

Excludes2 — not included here — inherited from Chapter 19

The conditions below are not part of T84.619A, but a patient may have both at the same time. When documentation supports it, T84.619A 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 T84.619A, but a patient may have both at the same time. When documentation supports it, T84.619A 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 T84

The conditions below are not part of T84.619A, but a patient may have both at the same time. When documentation supports it, T84.619A and the excluded code may both be reported.

failure and rejection of transplanted organs and tissues (T86.-)
fracture of bone following insertion of orthopedic implant, joint prosthesis or bone plate (M96.6)

How long has T84.619A existed?

T84.619A 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.