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ICD-10-CM Code T81.4
Infection following a procedure

Non-Billable Code
Non-Billable means the code is not sufficient justification for admission to an acute care hospital when used a principal diagnosis. Use a child code to capture more detail.
7th Character Required
7th Character Required
Code requires 7th Character Extension identifier. This 7th Character usually captures Episode of Care information, such as "Initial Encounter," "Subsquent Encounter," or "Sequela."
| ICD-10 from 2011 - 2016

ICD Code T81.4 is a non-billable code. To code a diagnosis of this type, you must use specify a 7th character that describes the diagnosis 'infection following a procedure' in more detail. The 7th characters that can be added, and the resulting billable codes, are as follows:

7th Digit Billable Code 7th Digit Specifies
A T81.4XXA initial encounter
D T81.4XXD subsequent encounter
S T81.4XXS sequela

What is 7th Character Extension?

For codes less than 6 characters that require a 7th character a placeholder 'X' should be assigned for all characters less than 6. The 7th character must always be the 7th position of a code. E.g. The ICD-10-CM code T67.4 (Heat exhaustion due to salt depletion) requires an Episode of Care identifier. T67.4XXA Initial Encounter or T67.4XXD Subsequent Encounter. More Info

Coding Notes for T81.4 Info for medical coders on how to properly use this ICD-10 code

Inclusion Terms:
Inclusion Terms
Inclusion Terms are a list of concepts for which a specific code is used. The list of Inclusion Terms is useful for determining the correct code in some cases, but the list is not necessarily exhaustive.
Intra-abdominal abscess following a procedure
Postprocedural infection, not elsewhere classified
Sepsis following a procedure
Stitch abscess following a procedure
Subphrenic abscess following a procedure
Wound abscess following a procedure
Additional Code Note:
Use Additional Code
Use Additional Code note means a second code must be used in conjunction with this code. Codes with this note are Etiology codes and must be followed by a Manifestation code or codes.
Code to identify infection
Code See code R65.2- to identify severe sepsis, if applicable
Code Type-1 Excludes:
Type-1 Excludes
Type-1 Excludes mean the conditions excluded are mutually exclusive and should never be coded together. Excludes 1 means "do not code here."
Obstetric surgical wound infection - instead, use code O86.0
Postprocedural fever NOS - instead, use code R50.82
Postprocedural retroperitoneal abscess - instead, use code K68.11
Code Type-2 Excludes:
Type-2 Excludes
Type-2 Excludes means the excluded conditions are different, although they may appear similar. A patient may have both conditions, but one does not include the other. Excludes 2 means "not coded here."
Bleb associated endophthalmitis - instead, use code H59.4-
Infection due to infusion, transfusion and therapeutic injection - instead, use code T80.2-
Infection due to prosthetic devices, implants and grafts (T82.6-T82.7, T83.5-T83.6, T84.5-T84.7, T85.7) - instead, use code T82.6-

Related Concepts SNOMET-CT

  • Methicillin-resistant Staphylococcus aureus infection of postoperative wound (disorder)
  • Organ-space surgical site infection (disorder)
  • Infected seroma after surgical procedure (disorder)
  • Postoperative abdominal wall wound abscess (disorder)
  • Postoperative subphrenic abscess (disorder)
  • Postoperative wound cellulitis (disorder)

Coding Advice SNOMET-CT

  • Possible requirement for causative agent code
  • Possible requirement for an external cause code
  • Possible requirement for additional code to fully describe disease or condition
  • Episode of care information needed
  • Consider additional code to identify specific condition or disease
  • Possible requirement for causative disease code

Parent Code: T81 - Complications of procedures, not elsewhere classified

** This Document Provided By ICD.Codes **
Source: http://icd.codes/icd10cm/T814