T86.39
T86.39: Other complications of heart-lung transplant
Billable / specific codeICD-10-CM
T86.39 is a billable, specific ICD-10-CM code for other complications of heart-lung transplant. It is valid for submission on a claim.
Check T86.39 with the rest of the claim: free scrubberOther codes that can never be billed with T86.39
Their own Excludes1 notes name this code, so the conflict is not listed above.
- Z98.85Transplanted organ removal status
Risk adjustment
T86.39 risk-adjusts. Under the CMS-HCC V28 model it maps to these categories:
- HCC 221 Heart Transplant Status/Complications1.053 RAF
- HCC 276 Lung Transplant Status/Complications2.531 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
T86.39 is named in 20 Medicare coverage policies: 20 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52466Nebulizers - Policy Article
- A52474Immunosuppressive Drugs - Policy Article
- A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
- A55717Billing and Coding: Lab: Flow Cytometry
Alphabetic index entries that lead here
- Complication›transplant›heart›cardiac allograft vasculopathy›specified type NEC
- Complication›transplant›lung›with heart›specified type NEC
The condition this code belongs to
Code history
Unchanged in every release from FY2024 to FY2027.