Infection following a procedure, organ and space surgical site

• birth trauma (P10-P15)
• obstetric trauma (O70-O71)

code to identify any retained foreign body, if applicable (Z18.-)

• Use secondary code(s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code
• The chapter uses the S-section for coding different types of injuries related to single body regions and the T-section to cover injuries to unspecified body regions as well as poisoning and certain other consequences of external causes.

• any encounters with medical care for postprocedural conditions in which no complications are present, such as:
• artificial opening status (Z93.-)
• closure of external stoma (Z43.-)
• fitting and adjustment of external prosthetic device (Z44.-)
• burns and corrosions from local applications and irradiation (T20-T32)
• complications of surgical procedures during pregnancy, childbirth and the puerperium (O00-O9A)
• mechanical complication of respirator [ventilator] (J95.850)
• poisoning and toxic effects of drugs and chemicals (T36-T65 with fifth or sixth character 1-4 or 6)
• postprocedural fever (R50.82)
• specified complications classified elsewhere, such as:
• cerebrospinal fluid leak from spinal puncture (G97.0)
• colostomy malfunction (K94.0-)
• disorders of fluid and electrolyte imbalance (E86-E87)
• functional disturbances following cardiac surgery (I97.0-I97.1)
• intraoperative and postprocedural complications of specified body systems (D78.-, E36.-, E89.-, G97.3-, G97.4, H59.3-, H59.-, H95.2-, H95.3, I97.4-, I97.5, J95.6-, J95.7, K91.6-, L76.-, M96.-, N99.-)
• ostomy complications (J95.0-, K94.-, N99.5-)
• postgastric surgery syndromes (K91.1)
• postlaminectomy syndrome NEC (M96.1)
• postmastectomy lymphedema syndrome (I97.2)
• postsurgical blind-loop syndrome (K91.2)
• ventilator associated pneumonia (J95.851)

• code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)
• code(s) to identify the specified condition resulting from the complication
• code to identify devices involved and details of circumstances (Y62-Y82)

• 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)

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

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

Wound abscess following a procedure

• bleb associated endophthalmitis (H59.4-)
• infection due to infusion, transfusion and therapeutic injection (T80.2-)
• infection due to prosthetic devices, implants and grafts (T82.6-T82.7, T83.5-T83.6, T84.5-T84.7, T85.7)
• obstetric surgical wound infection (O86.0-)
• postprocedural fever NOS (R50.82)
• postprocedural retroperitoneal abscess (K68.11)

• code to identify infection
• code (R65.2-) to identify severe sepsis, if applicable

, if applicable, disruption of internal operation (surgical) wound (T81.32-)