Kidney transplant ICD-10 code
The ICD-10-CM code for kidney transplant is Z94.0 (kidney transplant status). It is billable and valid for submission on a claim. There are 14 related codes, and which one you use depends on what the documentation supports.
Also written as renal transplant, transplant kidney.
The mistake coders make here
Z94.0 is transplant STATUS: a functioning graft, coded when the transplant is relevant history. T86.1- is for a transplant that is failing, rejecting, or infected. Coding Z94.0 when the graft is rejecting understates the encounter badly.
Putting kidney transplant on a claim? Check the claim’s diagnosis codes free: Excludes1 conflicts, header codes and missing seventh characters, before it goes out.
ICD-10-CM codes for kidney transplant
13 of 14 are billable. Green means you can submit it as-is.
| Code | Use it when |
|---|---|
| Z94.0 | Kidney transplant status |
| T86.11 | Kidney transplant rejection |
| T86.12 | Kidney transplant failure |
| T86.13 | Kidney transplant infection |
| T86.19 | Other complication of kidney transplant |
| T86.1 | Complications of kidney transplantnot billable on its own |
| T86.10 | Unspecified complication of kidney transplant |
| Z48.22 | Encounter for aftercare following kidney transplant |
| Z94.2 | Lung transplant status |
| Z94.5 | Skin transplant status |
| Z94.6 | Bone transplant status |
| T86.811 | Lung transplant failure |
| Z94.1 | Heart transplant status |
| Z94.4 | Liver transplant status |
Once you have the code
- Check the whole claim: Excludes1 conflicts and missing seventh characters, free
- Denial codes explained: what CO-16, CO-97 and the rest actually mean
- Decision guides: walk a chart note to a code, guideline cited
- Everything here that is free, and the one thing no free tool includes
Z94.0 is status; T86.1- is a complication, never both for the same problem
Z94.0, kidney transplant status, is for a patient with a functioning graft and no complication being addressed at this encounter. Once a complication of the transplant is documented, the T86.1- code replaces it for that condition: T86.10 unspecified complication, T86.11 rejection, T86.12 failure, T86.13 infection (with an additional code for the specific infection), T86.19 other complication. Do not report Z94.0 alongside a T86.1- code for the same kidney: the complication code already says a transplant exists.
CKD after a transplant is not automatically failure
This is the rule most often missed, and it is written into the Official Guidelines (Section I.C.14.a.2): a kidney transplant patient may still have some degree of chronic kidney disease, because the transplanted kidney may not fully restore function. CKD alone in a transplant patient does not mean the graft has failed or is being rejected. Code the CKD stage (N18.-) plus Z94.0. Assign T86.12 only when the provider documents transplant failure, and T86.11 only for documented rejection, and query when the note says 'declining graft function' without saying which.
The codes around the transplant
Z48.22 is the encounter for aftercare following kidney transplant, for the routine post-transplant visits with no complication. Z79.62- covers long-term (current) use of immunosuppressants, which applies to essentially every transplant recipient and should be on the claim. Z52.4 is the kidney donor. The transplant operation itself is ICD-10-PCS 0TY00Z0 (right, allogeneic) or 0TY10Z0 (left) on the inpatient record. A patient on dialysis after graft failure needs Z99.2 as well.
Common questions
- What is the ICD-10 code for kidney transplant status?
- Z94.0, kidney transplant status. Use it when the graft is functioning and no complication of the transplant is being treated at this encounter.
- How do I code CKD in a kidney transplant patient?
- Code the CKD stage (N18.-) and Z94.0. Per Official Guideline I.C.14.a.2, CKD in a transplant patient is not by itself a transplant complication. Use T86.12 (failure) or T86.11 (rejection) only when the provider documents that.
- What is the ICD-10 code for kidney transplant rejection?
- T86.11, kidney transplant rejection. Failure is T86.12, infection is T86.13 (with a code for the infection itself), and an unspecified complication is T86.10. Z94.0 is not added alongside these.