ICD-10-CM Billable Code

T85.49

Other mechanical complication of breast prosthesis and implant

Clinical Classification Guidelines

Inclusion Terms

  • Obstruction (mechanical) of breast prosthesis and implant
  • Perforation of breast prosthesis and implant
  • Protrusion of breast prosthesis and implant

Medical Intelligence & Overview

ICD-10 code T85.49 covers a range of mechanical complications related to breast prostheses and implants. These complications can involve issues such as obstructions, perforations, and protrusions that may affect the comfort, appearance, and function of reconstructed or augmented breasts. Recognizing these complications is important for patients and healthcare providers to ensure proper management and timely intervention.

Causes & Symptoms

Clinical Causes: Physical trauma or injury to the breast area Wear and tear of the implant over time Infection leading to degradation of implant structure Manufacturing defects or materials failure Improper placement during initial surgery Capsular contracture causing pressure on the implant Repeated cycles of filling and emptying in saline implants Exposure to extreme temperature variations Radiation therapy affecting tissue and implant integrity

Key Symptoms: Unusual swelling or lumps in the breast Pain or discomfort around the implant site Visible or palpable protrusion of the implant Perforation signs such as fluid leakage or implant breakage Changes in breast shape or asymmetry Protrusion or displacement of the implant Signs of infection like redness, warmth, or fever Decreased implant stability or mobility

Diagnostic & Treatment

Diagnosis Path: The diagnosis process involves a combination of medical history review, physical examination, and imaging studies. Common diagnostic tools include:

Treatment Protocols: Treatment options depend on the specific complication and its severity. Common interventions include:

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.

Clinical Advice & FAQs

Billing Guidance

Is T85.49 a billable ICD-10 code?
Yes, T85.49 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report T85.49?
Clinical documentation must specify the nature of Other mechanical complication of breast prosthesis and implant and any associated comorbidities for accurate reporting.

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