T82.228A: Other mechanical complication of biological heart valve graft, initial encounter
T82.228A, other mechanical complication of biological heart valve graft, initial encounter, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 19 HCPCS Level II codes, including J0461 (Injection, atropine sulfate, 0.01 mg), J0153 (Injection, adenosine, 1 mg (not to be used to report any…), J1250 (Injection, dobutamine hydrochloride, per 250 mg). The articles come from 3 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with T82.228A as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| J0461 | Injection, atropine sulfate, 0.01 mg | Special coverage instructions apply | — | 3 |
| J0153 | Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds) | Special coverage instructions apply | — | 3 |
| J1250 | Injection, dobutamine hydrochloride, per 250 mg | Special coverage instructions apply | — | 3 |
| J0280 | Injection, aminophyllin, up to 250 mg | Special coverage instructions apply | — | 3 |
| J1245 | Injection, dipyridamole, per 10 mg | Special coverage instructions apply | — | 3 |
| A9700 | Supply of injectable contrast material for use in echocardiography, per study | Special coverage instructions apply | — | 3 |
| J2785 | Injection, regadenoson, 0.1 mg | Carrier judgment | — | 2 |
| Q9957 | Injection, perflutren lipid microspheres, per ml | Carrier judgment | — | 2 |
| Q9956 | Injection, octafluoropropane microspheres, per ml | Carrier judgment | — | 2 |
| C8921 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; complete | Special coverage instructions apply | — | 2 |
| C8922 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; follow-up or limited study | Special coverage instructions apply | — | 2 |
| C8923 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, without spectral or color doppler echocardiography | Special coverage instructions apply | — | 2 |
| C8924 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, follow-up or limited study | Special coverage instructions apply | — | 2 |
| C8928 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report | Special coverage instructions apply | — | 2 |
| C8929 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography | Special coverage instructions apply | — | 2 |
| C8930 | Transthoracic echocardiography, with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuous electrocardiographic monitoring, with physician supervision | Special coverage instructions apply | — | 2 |
| Q9955 | Injection, perflexane lipid microspheres, per ml | Carrier judgment | — | 2 |
| J3490 | Unclassified drugs | Special coverage instructions apply | — | 1 |
| C9399 | Unclassified drugs or biologicals | Special coverage instructions apply | — | 1 |
Medicare policy articles listing T82.228A
- A57306: Billing and Coding: Transthoracic Echocardiography (TTE) (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 19 Level II codes). LCD with the same title: L33577, L34338
- A56781: Billing and Coding: Transthoracic Echocardiography (TTE) (Wellpoint Federal (MAC - Part A, MAC - Part B); 17 Level II codes). LCD with the same title: L33577, L34338
- A56625: Billing and Coding: Echocardiography (Palmetto GBA (MAC - Part A, MAC - Part B); 6 Level II codes). LCD with the same title: L37379
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other T82 diagnoses (Complications of cardiac and vascular prosthetic devices, implants and grafts)
- T82.221A — Breakdown (mechanical) of biological heart valve graft, initial…
- T82.222A — Displacement of biological heart valve graft, initial encounter
- T82.223A — Leakage of biological heart valve graft, initial encounter
- T82.211A — Breakdown (mechanical) of coronary artery bypass graft, initial…
- T82.212A — Displacement of coronary artery bypass graft, initial encounter
- T82.213A — Leakage of coronary artery bypass graft, initial encounter
- T82.218A — Other mechanical complication of coronary artery bypass graft…
- T82.01XA — Breakdown (mechanical) of heart valve prosthesis, initial encounter
- T82.02XA — Displacement of heart valve prosthesis, initial encounter
- T82.03XA — Leakage of heart valve prosthesis, initial encounter
- T82.09XA — Other mechanical complication of heart valve prosthesis, initial…
- T82.110A — Breakdown (mechanical) of cardiac electrode, initial encounter
- T82.111A — Breakdown (mechanical) of cardiac pulse generator (battery), initial…
- T82.118A — Breakdown (mechanical) of other cardiac electronic device, initial…
- T82.119A — Breakdown (mechanical) of unspecified cardiac electronic device…
- T82.120A — Displacement of cardiac electrode, initial encounter
- T82.121A — Displacement of cardiac pulse generator (battery), initial encounter
- T82.128A — Displacement of other cardiac electronic device, initial encounter
- T82.129A — Displacement of unspecified cardiac electronic device, initial…
- T82.190A — Other mechanical complication of cardiac electrode, initial encounter
- T82.191A — Other mechanical complication of cardiac pulse generator (battery)…
- T82.198A — Other mechanical complication of other cardiac electronic device…
- T82.199A — Other mechanical complication of unspecified cardiac device, initial…
- T82.310A — Breakdown (mechanical) of aortic (bifurcation) graft (replacement)…
- T82.311A — Breakdown (mechanical) of carotid arterial graft (bypass), initial…
- T82.312A — Breakdown (mechanical) of femoral arterial graft (bypass), initial…
- T82.318A — Breakdown (mechanical) of other vascular grafts, initial encounter
- T82.319A — Breakdown (mechanical) of unspecified vascular grafts, initial…
- T82.320A — Displacement of aortic (bifurcation) graft (replacement), initial…
- T82.321A — Displacement of carotid arterial graft (bypass), initial encounter
Frequently asked questions
Does Medicare cover T82.228A (Other mechanical complication of biological heart valve…)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list T82.228A as a covered diagnosis for 19 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 T82.228A?
The Level II codes from the policies most specific to this diagnosis are J0461 (Injection, atropine sulfate, 0.01 mg, 3 articles); J0153 (Injection, adenosine, 1 mg (not to be used to report any…, 3 articles); J1250 (Injection, dobutamine hydrochloride, per 250 mg, 3 articles); J0280 (Injection, aminophyllin, up to 250 mg, 3 articles); J1245 (Injection, dipyridamole, per 10 mg, 3 articles). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list T82.228A?
A57306 (Billing and Coding: Transthoracic Echocardiography (TTE)); A56781 (Billing and Coding: Transthoracic Echocardiography (TTE)); A56625 (Billing and Coding: Echocardiography).
What is ICD-10-CM code T82.228A?
T82.228A is the ICD-10-CM code for other mechanical complication of biological heart valve graft, initial encounter, in category T82 (Complications of cardiac and vascular prosthetic devices, implants and grafts), chapter 19: Injury, poisoning and other consequences of external causes.
Next steps
- Run a reimbursement report for a device billed under J0461
- Watch J0461 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0461
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 19: Injury, poisoning and other consequences of external causes · All diagnoses · HCPCS lookup