Is T86.5 a billable ICD-10-CM code?

Yes. T86.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does T86.5 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).

T86.5

T86.5 — Complications of stem cell transplant

Billable / specific codeICD-10-CM

T86.5 is a billable, specific ICD-10-CM code for complications of stem cell transplant. It is valid for submission on a claim.

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Complications from stem cells from peripheral blood
Complications from stem cells from umbilical cord

Risk adjustment

T86.5 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.

Medicare coverage

T86.5 is named in 27 Medicare coverage policies — 27 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 T86.5 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 T86.5.

Complication›transplant›peripheral blood stem cells
Complication›transplant›stem cell(from peripheral blood) (from umbilical cord)
Complication›transplant›umbilical cord stem cells
Failure, failed›transplant›stem cell(peripheral blood) (umbilical cord)
Rejection›transplant›stem cell(peripheral blood) (umbilical cord)

Related codes at this level

Codes that share T86. If T86.5 is not quite right, the correct code is usually one of these.

Questions about T86.5

Is T86.5 a billable ICD-10-CM code?: Yes. T86.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does T86.5 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).