T85.738A — Infection and inflammatory reaction due to other nervous system device, implant or graft, initial encounter
Is T85.738A billable?
Yes — T85.738A is billable for FY2027. T85.738A is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. T85.738A may be submitted for encounters from October 1, 2026 through September 30, 2027.
T85.738A at a glance
| Code | T85.738A |
|---|---|
| Description | Infection and inflammatory reaction due to other nervous system device, implant or graft, 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 T85.738A?
In T85.738A, the 7th character A means initial encounter. The 7th character is required for T85.738A to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
Which MS-DRGs does T85.738A group to?
T85.738A sits in MDC 01 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.
- 091Other Disorders of Nervous System with MCCmedical
- 092Other Disorders of Nervous System with CCmedical
- 093Other Disorders of Nervous System without CC/MCCmedical
As a secondary diagnosis, T85.738A is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is T85.738A listed in the Alphabetic Index?
The Alphabetic Index lists these routes under T85.738, the nearest indexed parent of T85.738A. Use them to find the family, then select the specific code.
- Complication › intrathecal infusion pump › infection and inflammation (s) (from) (of)
- Complication › electronic stimulator device › nervous system › infection and inflammation (s) (from) (of)
- Inflammation, inflamed, inflammatory › due to device, implant or graft › electronic › nervous system (with exudation)
- Sepsis › due to device, implant or graft › electronic › nervous system (generalized) (unspecified organism)
- Complication › nervous system › device, implant or graft › specified NEC › infection and inflammation (s) (from) (of)
- Infection, infected, infective › due to or resulting from › device, implant or graft › electronic › nervous system (opportunistic)
Inclusion terms
Alternative wording in documentation that is classified to T85.738A.
- Infection and inflammatory reaction due to intrathecal infusion pump
Use additional code — inherited from Chapter 19
Report an additional code alongside T85.738A to fully describe the condition. T85.738A 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 T85.738A to fully describe the condition. T85.738A is sequenced first.
Use additional code — inherited from T85.7
Report an additional code alongside T85.738A to fully describe the condition. T85.738A is sequenced first.
- code to identify infection
Excludes2 — not included here — inherited from Chapter 19
The conditions below are not part of T85.738A, but a patient may have both at the same time. When documentation supports it, T85.738A and the excluded code may both be reported.
Excludes2 — not included here — inherited from T80-T88
The conditions below are not part of T85.738A, but a patient may have both at the same time. When documentation supports it, T85.738A 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 T85.738A, but a patient may have both at the same time. When documentation supports it, T85.738A and the excluded code may both be reported.
- failure and rejection of transplanted organs and tissue (T86.-)
How long has T85.738A existed?
T85.738A first appears in FY2018 (FY2017 is not available, so it may have appeared then).
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.