ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 T85.692

Non-Billable Header

Other mechanical complication of permanent sutures

T85
Block
0
Synonyms
0
LCDs
0
Payer Policies
0
Linked CPTs

About ICD-10-CM T85.692

ICD-10-CM code T85.692 represents Other mechanical complication of permanent sutures. This is a non-billable header code in the Injury, Poisoning, and External Causes chapter (block T85). The 2026 edition of ICD-10-CM T85.692 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.

Coding Tips for T85.692

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

Injury chapter (S00-T88): 7th character extension required

Injury codes require a 7th character: A (initial encounter, active treatment), D (subsequent, healing/recovery), S (sequela, late effect of original injury). Codes with fewer than 6 characters need the placeholder X to bring them to 6 characters before adding the 7th. Wrong or missing 7th character is the #1 cause of injury claim denials.

Type 1 Excludes

Pure excludes, these codes can never be coded together with T85.692. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • mechanical complication of permanent (wire) suture used in bone repair (T84.1-T84.2)

Medicare LCD Coverage for T85.692

Local Coverage Determinations (LCDs) from CMS MACs that list T85.692 as a covered diagnosis.

No Medicare LCDs reference T85.692 as covered

This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.

Commercial Payer Coverage

Coverage policies from major commercial payers referencing T85.692.

No commercial payer policies reference T85.692 on file

Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but T85.692 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.

CPT Codes Commonly Billed with T85.692

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for T85.692

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Codes Adjacent To T85.692

Other codes in section T80-T88 (Complications of surgical and medical care, not elsewhere classified).

T80 Complications following infusion, transfusion and therapeutic injection (non-billable) T80.0 Air embolism following infusion, transfusion and therapeutic injection (non-billable) T80.1 Vascular complications following infusion, transfusion and therapeutic injection (non-billable) T80.2 Infections following infusion, transfusion and therapeutic injection (non-billable) T80.21 Infection due to central venous catheter (non-billable) T80.211 Bloodstream infection due to central venous catheter (non-billable) T80.212 Local infection due to central venous catheter (non-billable) T80.218 Other infection due to central venous catheter (non-billable) T80.219 Unspecified infection due to central venous catheter (non-billable) T80.22 Acute infection following transfusion, infusion, or injection of blood and blood products (non-billable) T80.29 Infection following other infusion, transfusion and therapeutic injection (non-billable) T80.3 ABO incompatibility reaction due to transfusion of blood or blood products (non-billable) T80.30 ABO incompatibility reaction due to transfusion of blood or blood products, unspecified (non-billable) T80.31 ABO incompatibility with hemolytic transfusion reaction (non-billable) T80.310 ABO incompatibility with acute hemolytic transfusion reaction (non-billable) T80.311 ABO incompatibility with delayed hemolytic transfusion reaction (non-billable) T80.319 ABO incompatibility with hemolytic transfusion reaction, unspecified (non-billable) T80.39 Other ABO incompatibility reaction due to transfusion of blood or blood products (non-billable) T80.4 Rh incompatibility reaction due to transfusion of blood or blood products (non-billable) T80.40 Rh incompatibility reaction due to transfusion of blood or blood products, unspecified (non-billable)

ICD-10 T85.692, Billing FAQ

Is ICD-10 code T85.692 billable? +

No, T85.692 is a non-billable header code. Use a more specific child code from block T85 when submitting claims.

What codes are Type 1 Excludes for T85.692? +

Type 1 Excludes (never code together with T85.692): mechanical complication of permanent (wire) suture used in bone repair (T84.1-T84.2)

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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