ICD-10 Y81.3
Billable / SpecificSurgical instruments, materials and general- and plastic-surgery devices (including sutures) associated with adverse incidents
About ICD-10-CM Y81.3
ICD-10-CM code Y81.3 represents Surgical instruments, materials and general- and plastic-surgery devices (including sutures) associated with adverse incidents. This is a billable/specific code in the External Causes of Morbidity chapter (block Y81). The 2026 edition of ICD-10-CM Y81.3 became effective on October 1, 2025.
Medicare LCD Coverage for Y81.3
Local Coverage Determinations (LCDs) from CMS MACs that list Y81.3 as a covered diagnosis.
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 Y81.3.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but Y81.3 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with Y81.3
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
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 Y81.3 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| Y81.3 | NoDx | 11000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To Y81.3
Other codes in section Y70-Y82 (Medical devices associated with adverse incidents in diagnostic and therapeutic use).
ICD-10 Y81.3, Billing FAQ
Is ICD-10 code Y81.3 billable? +
Yes, Y81.3 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What ICD-9 codes does Y81.3 map to? +
Per CMS GEMs, Y81.3 maps to ICD-9 codes: NoDx. 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 May 31, 2026.
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