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

ICD-10 T87.2

Billable / Specific HCC v28: 173 CC

Complications of other reattached body part

T87
Block
0
Synonyms
187
LCDs
4
Payer Policies
0
Linked CPTs

About ICD-10-CM T87.2

ICD-10-CM code T87.2 represents Complications of other reattached body part. This is a billable/specific code in the Injury, Poisoning, and External Causes chapter (block T87). The 2026 edition of ICD-10-CM T87.2 became effective on October 1, 2025.

Coding Tips for T87.2

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

HCC capture: document with MEAT each year

T87.2 is a CMS-HCC v28 risk-adjustment code (category 173). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.

Inpatient DRG impact: CC

T87.2 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

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.

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 173
ESRD-HCC
Category 173
RxHCC (Part D)
Category 173

Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.

Inpatient DRG Impact, CC

codes Complications of other reattached body part. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for T87.2

Local Coverage Determinations (LCDs) from CMS MACs that list T87.2 as a covered diagnosis.

187 LCDs

Showing top 10 of 187 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 29131 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 29260 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 29580 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 97036 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 29445 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 97542 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 97110 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 97533 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 29130 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 29405 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing T87.2.

4 policies

3 Medicare

Billing and Coding: Home Health Physical Therapy
Policy ID: ART-53058
Billing and Coding: Outpatient Physical Therapy
Policy ID: ART-53065
Billing and Coding: Physical Therapy - Home Health
Policy ID: ART-57311

1 Aetna

Bio-Surgery: Medicinal Leech Therapy and Medical Maggots
Policy ID: CPB-0556

CPT Codes Commonly Billed with T87.2

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

No procedure linkages on file for T87.2

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.

Convert T87.2 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
T87.2 99699 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

Codes Adjacent To T87.2

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 T87.2, Billing FAQ

Is ICD-10 code T87.2 billable? +

Yes, T87.2 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Does T87.2 affect Medicare Advantage HCC risk adjustment? +

Yes. T87.2 maps to CMS-HCC v28 category 173. Capture this diagnosis annually for accurate Medicare Advantage risk score.

Is T87.2 a CC or MCC for inpatient DRG? +

Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.

What ICD-9 codes does T87.2 map to? +

Per CMS GEMs, T87.2 maps to ICD-9 codes: 99699. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on July 16, 2026.

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