Is T81 a billable ICD-10-CM code?

No. T81 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does T81 sit in the tabular list?

Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Complications of surgical and medical care, not elsewhere classified (T80-T88).

T81

T81 — Complications of procedures, not elsewhere classified

Non-billable headerICD-10-CM

T81 is a non-billable header ICD-10-CM code for complications of procedures, not elsewhere classified. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.

This code requires a 7th character

The appropriate 7th character is to be added to each code from category T81

A: initial encounter
D: subsequent encounter
S: sequela

Excludes2 — not included here, but may coexist

The excluded condition is not part of this code, but a patient can have both. You may code both.

complications following immunization (T88.0-T88.1)
complications following infusion, transfusion and therapeutic injection (T80.-)
complications of transplanted organs and tissue (T86.-)
specified complications classified elsewhere, such as:
complication of prosthetic devices, implants and grafts (T82-T85)
dermatitis due to drugs and medicaments (L23.3, L24.4, L25.1, L27.0-L27.1)
endosseous dental implant failure (M27.6-)
floppy iris syndrome (IFIS) (intraoperative) H21.81
intraoperative and postprocedural complications of specific body system (D78.-, E36.-, E89.-, G97.3-, G97.4, H59.3-, H59.-, H95.2-, H95.3, I97.4-, I97.5, J95, K91.-, L76.-, M96.-, N99.-)
ostomy complications (J95.0-, K94.-, N99.5-)
plateau iris syndrome (post-iridectomy) (postprocedural) H21.82
poisoning and toxic effects of drugs and chemicals (T36-T65 with fifth or sixth character 1-4)

Use additional code

Add a secondary code to capture the detail described below.

code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)

Other codes that can never be billed with T81

These codes carry an Excludes1 note pointing at T81. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading T81 alone.

O86.0Infection of obstetric surgical wound
R50.82Postprocedural fever
R55Syncope and collapse
R57Shock, not elsewhere classified
R65.21Severe sepsis with septic shock
E86Volume depletion
J43Emphysema
J98.2Interstitial emphysema

Risk adjustment

T81 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Code to one of these instead T81

8 child codes. Green means billable.

Questions about T81

Is T81 a billable ICD-10-CM code?: No. T81 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does T81 sit in the tabular list?: Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Complications of surgical and medical care, not elsewhere classified (T80-T88).