T86.811 — Lung transplant failure
T86.811 is a billable, specific ICD-10-CM code for lung transplant failure. It is valid for submission on a claim.
Excludes1 inherited from the categories above T86.811
These are not written on T86.811, but they bind it: a note on a category applies to every code beneath it. Billing T86.811 with anything listed here is a denial.
Other codes that can never be billed with T86.811
These codes carry an Excludes1 note pointing at T86.811. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading T86.811 alone.
- Z98.85Transplanted organ removal status
Risk adjustment
T86.811 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- 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.
Medicare coverage
T86.811 is named in 16 Medicare coverage policies — 16 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52466Nebulizers - Policy Article
- A52466Nebulizers - Policy Article
- A52466Nebulizers - Policy Article
- A52466Nebulizers - Policy Article
How T86.811 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to T86.811.
- Failure, failed›transplant›lung(s)
- Complication›transplant›lung›failure
The condition this code belongs to
Every code for the condition on one page, which one applies when, and the mistake coders make with it.
Code history
T86.811 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share T86.81. If T86.811 is not quite right, the correct code is usually one of these.
Questions about T86.811
- Is T86.811 a billable ICD-10-CM code?
- Yes. T86.811 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T86.811 sit in the tabular list?
- Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Complications of surgical and medical care, not elsewhere classified (T80-T88).
- What cannot be coded together with T86.811?
- T86.811 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above T86.811 (T86.81) and apply to it just the same.