Is T81.1 a billable ICD-10-CM code?

No. T81.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does T81.1 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).

What cannot be coded together with T81.1?

T81.1 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

T81.1

T81.1 — Postprocedural shock

Non-billable headerICD-10-CM

T81.1 is a non-billable header ICD-10-CM code for postprocedural shock. 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

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

anaphylactic shock NOS (T78.2)
anaphylactic shock due to correct substance properly administered (T88.6)
anaphylactic shock due to serum (T80.5-)
electric shock (T75.4)
obstetric shock (O75.1)
shock due to anesthesia (T88.2)
shock following abortion or ectopic or molar pregnancy (O00-O07, O08.3)
traumatic shock (T79.4)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Shock during or resulting from a procedure, not elsewhere classified

Other codes that can never be billed with T81.1

These codes carry an Excludes1 note pointing at T81.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading T81.1 alone.

R55Syncope and collapse
R57Shock, not elsewhere classified
R65.21Severe sepsis with septic shock
E86Volume depletion
T79.4Traumatic shock
T79.4XXATraumatic shock, initial encounter
T79.4XXDTraumatic shock, subsequent encounter
T79.4XXSTraumatic shock, sequela

Risk adjustment

T81.1 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 T81.1

4 child codes. Green means billable.

Related codes at this level

Codes that share T81. If T81.1 is not quite right, the correct code is usually one of these.

Questions about T81.1

Is T81.1 a billable ICD-10-CM code?: No. T81.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does T81.1 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).
What cannot be coded together with T81.1?: T81.1 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.