M31.11: Hematopoietic stem cell transplantation-associated thrombotic microangiopathy [HSCT-TMA]
M31.11 is a billable, specific ICD-10-CM code for hematopoietic stem cell transplantation-associated thrombotic microangiopathy [hsct-tma]. It is valid for submission on a claim.
Check M31.11 with the rest of the claim: free scrubberCode first
The underlying condition must be sequenced before this code.
Use additional code
Add a secondary code to capture the detail described below.
- code to identify specific organ dysfunction, such as:
- acute kidney failure (N17.-)
- acute respiratory distress syndrome (J80)
- capillary leak syndrome (I78.8)
- diffuse alveolar hemorrhage (R04.89)
- encephalopathy (metabolic) (septic) (G93.41)
- fluid overload, unspecified (E87.70)
- graft versus host disease (D89.81-)
- hemolytic uremic syndrome (D59.3-)
- hepatic failure (K72.-)
- hepatic veno-occlusive disease (K76.5)
- idiopathic interstitial pneumonia (J84.11-)
- sinusoidal obstruction syndrome (K76.5)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Transplant-associated thrombotic microangiopathy [TA-TMA]
Risk adjustment
M31.11 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 454 Stem Cell, Including Bone Marrow, Transplant Status/Complications1.068 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
M31.11 is named in 18 Medicare coverage policies: 11 listing it as supporting medical necessity, and 7 listing it as NOT covered. Which one applies depends on your Medicare contractor.
- A58865Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A58883Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A58893Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A59374Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
Alphabetic index entries that lead here
- HSCT-TMA(hematopoietic stem cell transplantation-associated thrombotic microangiopathy)
- Microangiopathy›thrombotic›hematopoietic stem cell transplantation-associated [HSCT-TMA]
Code history
Unchanged in every release from FY2024 to FY2027.