T85.898A: Other specified complication of other internal prosthetic devices, implants and grafts, initial encounter
T85.898A, other specified complication of other internal prosthetic devices, implants and grafts, initial encounter, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 4 HCPCS Level II codes, including Q2028 (Injection, sculptra, 0.5 mg), G0429 (Dermal filler injection(s) for the treatment of facial…), Q2026 (Injection, radiesse, 0.1 ml). 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 T85.898A as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| Q2028 | Injection, sculptra, 0.5 mg | Special coverage instructions apply | — | 2 |
| G0429 | Dermal filler injection(s) for the treatment of facial lipodystrophy syndrome (lds) (e.g., as a result of highly active antiretroviral therapy) | Carrier judgment | — | 2 |
| Q2026 | Injection, radiesse, 0.1 ml | Special coverage instructions apply | — | 2 |
| G0451 | Development testing, with interpretation and report, per standardized instrument form | Carrier judgment | — | 1 |
Medicare policy articles listing T85.898A
- A52866: Billing and Coding: Speech-Language Pathology (Wellpoint Federal (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33580, L34046
- A59299: Billing and Coding: Cosmetic and Reconstructive Surgery (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L33428, L35090, L38914, L39051
- A58774: Billing and Coding: Cosmetic and Reconstructive Surgery (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L33428, L35090, L38914, L39051
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 T85 diagnoses (Complications of other internal prosthetic devices, implants and grafts)
- T85.01XA — Breakdown (mechanical) of ventricular intracranial (communicating)…
- T85.02XA — Displacement of ventricular intracranial (communicating) shunt…
- T85.03XA — Leakage of ventricular intracranial (communicating) shunt, initial…
- T85.09XA — Other mechanical complication of ventricular intracranial…
- T85.110A — Breakdown (mechanical) of implanted electronic neurostimulator of…
- T85.111A — Breakdown (mechanical) of implanted electronic neurostimulator of…
- T85.113A — Breakdown (mechanical) of implanted electronic neurostimulator…
- T85.120A — Displacement of implanted electronic neurostimulator of brain…
- T85.121A — Displacement of implanted electronic neurostimulator of peripheral…
- T85.123A — Displacement of implanted electronic neurostimulator, generator…
- T85.191A — Other mechanical complication of implanted electronic…
- T85.193A — Other mechanical complication of implanted electronic…
- T85.41XA — Breakdown (mechanical) of breast prosthesis and implant, initial…
- T85.42XA — Displacement of breast prosthesis and implant, initial encounter
- T85.43XA — Leakage of breast prosthesis and implant, initial encounter
- T85.44XA — Capsular contracture of breast implant, initial encounter
- T85.49XA — Other mechanical complication of breast prosthesis and implant…
- T85.71XA — Infection and inflammatory reaction due to peritoneal dialysis…
- T85.72XA — Infection and inflammatory reaction due to insulin pump, initial…
- T85.79XA — Infection and inflammatory reaction due to other internal prosthetic…
Frequently asked questions
Does Medicare cover T85.898A (Other specified complication of other internal prosthetic…)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list T85.898A as a covered diagnosis for 4 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 T85.898A?
The Level II codes from the policies most specific to this diagnosis are Q2028 (Injection, sculptra, 0.5 mg, 2 articles); G0429 (Dermal filler injection(s) for the treatment of facial…, 2 articles); Q2026 (Injection, radiesse, 0.1 ml, 2 articles); G0451 (Development testing, with interpretation and report, per…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list T85.898A?
A52866 (Billing and Coding: Speech-Language Pathology); A59299 (Billing and Coding: Cosmetic and Reconstructive Surgery); A58774 (Billing and Coding: Cosmetic and Reconstructive Surgery).
What is ICD-10-CM code T85.898A?
T85.898A is the ICD-10-CM code for other specified complication of other internal prosthetic devices, implants and grafts, initial encounter, in category T85 (Complications of other internal 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 Q2028
- Watch Q2028 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q2028
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