T84.53XA: Infection and inflammatory reaction due to internal right knee prosthesis, initial encounter

T84.53XA, infection and inflammatory reaction due to internal right knee prosthesis, initial encounter, is listed as a covered diagnosis in 11 Medicare billing and coding articles that apply to 85 HCPCS Level II codes, including U0002 (2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19)…), U0001 (Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr…), C8925 (Transesophageal echocardiography (tee) with contrast, or…). 47 of these codes have a 2026 DMEPOS fee schedule amount; L1844 pays $1,865.51 to $2,436.24 depending on the state. The articles come from 5 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 T84.53XA as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
U00022019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdcCarrier judgment—4
U0001Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panelCarrier judgment—4
C8925Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, real time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and reportSpecial coverage instructions apply—2
C8926Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and reportSpecial coverage instructions apply—2
C8927Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (dynamically changing) cardiac pumping function and to therapeutic measures on an immediate time basisSpecial coverage instructions apply—2
J2785Injection, regadenoson, 0.1 mgCarrier judgment—2
J0461Injection, atropine sulfate, 0.01 mgSpecial coverage instructions apply—2
J0153Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds)Special coverage instructions apply—2
Q9957Injection, perflutren lipid microspheres, per mlCarrier judgment—2
J1250Injection, dobutamine hydrochloride, per 250 mgSpecial coverage instructions apply—2
J0280Injection, aminophyllin, up to 250 mgSpecial coverage instructions apply—2
J1245Injection, dipyridamole, per 10 mgSpecial coverage instructions apply—2
Q9956Injection, octafluoropropane microspheres, per mlCarrier judgment—2
A9700Supply of injectable contrast material for use in echocardiography, per studySpecial coverage instructions apply—2
C8921Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; completeSpecial coverage instructions apply—2
C8922Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; follow-up or limited studySpecial coverage instructions apply—2
C8923Transthoracic 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 echocardiographySpecial coverage instructions apply—2
C8924Transthoracic 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 studySpecial coverage instructions apply—2
C8928Transthoracic 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 reportSpecial coverage instructions apply—2
C8929Transthoracic 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 echocardiographySpecial coverage instructions apply—2
C8930Transthoracic 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 supervisionSpecial coverage instructions apply—2
Q9955Injection, perflexane lipid microspheres, per mlCarrier judgment—2
J3490Unclassified drugsSpecial coverage instructions apply—1
C9399Unclassified drugs or biologicalsSpecial coverage instructions apply—1
L1844Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricatedCarrier judgment$1,865.51–$2,436.241

60 more codes are listed. See every code with payment by region in Caduvo.

Medicare policy articles listing T84.53XA

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 T84 diagnoses (Complications of internal orthopedic prosthetic devices, implants and grafts)

Frequently asked questions

Does Medicare cover T84.53XA (Infection and inflammatory reaction due to internal right…)?

Medicare covers items and services, not diagnoses. 11 Medicare billing and coding articles list T84.53XA as a covered diagnosis for 85 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 T84.53XA?

The Level II codes from the policies most specific to this diagnosis are U0002 (2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19)…, 4 articles); U0001 (Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr…, 4 articles); C8925 (Transesophageal echocardiography (tee) with contrast, or…, 2 articles); C8926 (Transesophageal echocardiography (tee) with contrast, or…, 2 articles); C8927 (Transesophageal echocardiography (tee) with contrast, or…, 2 articles). Code choice depends on the item supplied; check each code's descriptor.

What does Medicare pay for equipment billed with T84.53XA?

Under the 2026 DMEPOS fee schedule (non-rural state fees): L1844 $1,865.51 to $2,436.24; L1860 $1,233.07 to $1,985.94; L1846 $1,283.72 to $1,960.17; L1834 $892.02 to $1,808.36. Medicare pays 80% of the allowed amount after the Part B deductible.

Which Medicare policy articles list T84.53XA?

A56809 (Billing and Coding: Transesophageal Echocardiography (TEE)); A52868 (Billing and Coding: Transesophageal Echocardiography (TEE)); A58710 (Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing), and 8 more articles.

What is ICD-10-CM code T84.53XA?

T84.53XA is the ICD-10-CM code for infection and inflammatory reaction due to internal right knee prosthesis, initial encounter, in category T84 (Complications of internal orthopedic prosthetic devices, implants and grafts), chapter 19: Injury, poisoning and other consequences of external causes.

Next steps

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