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.
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 17 Medicare coverage policies — 17 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
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).