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ICD-10-CM · FY 2026 APRIL UPDATE

T85.4

Mechanical complication of breast prosthesis and implant

Diagnosis reference

Nonbillable category

This entry is a category or subcategory. Choose the appropriate billable descendant based on the clinical documentation.

Effective periodOctober 1, 2026–September 30, 2027
SourceCMS ICD-10-CM order file
ClassificationDiagnosis · clinical modification

Related entries

Up to 30 descendants in this category

CODEDESCRIPTIONTYPE
T85.41Breakdown (mechanical) of breast prosthesis and implantCategory
T85.41XABreakdown (mechanical) of breast prosthesis and implant, initial encounterBillable
T85.41XDBreakdown (mechanical) of breast prosthesis and implant, subsequent encounterBillable
T85.41XSBreakdown (mechanical) of breast prosthesis and implant, sequelaBillable
T85.42Displacement of breast prosthesis and implantCategory
T85.42XADisplacement of breast prosthesis and implant, initial encounterBillable
T85.42XDDisplacement of breast prosthesis and implant, subsequent encounterBillable
T85.42XSDisplacement of breast prosthesis and implant, sequelaBillable
T85.43Leakage of breast prosthesis and implantCategory
T85.43XALeakage of breast prosthesis and implant, initial encounterBillable
T85.43XDLeakage of breast prosthesis and implant, subsequent encounterBillable
T85.43XSLeakage of breast prosthesis and implant, sequelaBillable
T85.44Capsular contracture of breast implantCategory
T85.44XACapsular contracture of breast implant, initial encounterBillable
T85.44XDCapsular contracture of breast implant, subsequent encounterBillable
T85.44XSCapsular contracture of breast implant, sequelaBillable
T85.49Other mechanical complication of breast prosthesis and implantCategory
T85.49XAOther mechanical complication of breast prosthesis and implant, initial encounterBillable
T85.49XDOther mechanical complication of breast prosthesis and implant, subsequent encounterBillable
T85.49XSOther mechanical complication of breast prosthesis and implant, sequelaBillable

Use the complete reference

This reference does not reproduce the full tabular hierarchy, inclusion notes, Excludes1/2 notes, sequencing instructions, or seventh-character rules. Review the official tables and coding guidelines.

Open official CMS files

ICD-10-CM codes describe diagnoses. They do not have an independent Medicare PFS reimbursement amount, and billability alone does not establish coverage.