ICDcodes.org
FY2027

T85.72XA — Infection and inflammatory reaction due to insulin pump, initial encounter

BillableCC

Is T85.72XA billable?

Yes — T85.72XA is billable for FY2027. T85.72XA is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. T85.72XA may be submitted for encounters from October 1, 2026 through September 30, 2027.

T85.72XA at a glance

CodeT85.72XA
DescriptionInfection and inflammatory reaction due to insulin pump, initial encounter
BillableYes
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027
7th character "A"initial encounter

What does the 7th character "A" mean in T85.72XA?

In T85.72XA, the 7th character A means initial encounter. The 7th character is required for T85.72XA to be a valid, complete code.

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

Which MS-DRGs does T85.72XA group to?

T85.72XA sits in MDC 21 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.

  • 919Complications of Treatment with MCCmedical
  • 920Complications of Treatment with CCmedical
  • 921Complications of Treatment without CC/MCCmedical

As a secondary diagnosis, T85.72XA is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.

How is T85.72XA listed in the Alphabetic Index?

The Alphabetic Index lists these routes under T85.72, the nearest indexed parent of T85.72XA. Use them to find the family, then select the specific code.

  • Complication › insulin pump › infection and inflammation (s) (from) (of)

Use additional code — inherited from Chapter 19

Report an additional code alongside T85.72XA to fully describe the condition. T85.72XA 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 T85.72XA to fully describe the condition. T85.72XA 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 T85.7

Report an additional code alongside T85.72XA to fully describe the condition. T85.72XA is sequenced first.

  • code to identify infection

Excludes2 — not included here — inherited from Chapter 19

The conditions below are not part of T85.72XA, but a patient may have both at the same time. When documentation supports it, T85.72XA 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 T85.72XA, but a patient may have both at the same time. When documentation supports it, T85.72XA 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 T85

The conditions below are not part of T85.72XA, but a patient may have both at the same time. When documentation supports it, T85.72XA and the excluded code may both be reported.

  • failure and rejection of transplanted organs and tissue (T86.-)

How long has T85.72XA existed?

T85.72XA 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.