T86.41 Liver Transplant Rejection Maps to HCC 62 in V28. T86.4 Is Not Billable.

If you searched T86.41, liver transplant rejection, or Z94.4 next to V28, you are looking at a transplant cluster where the transplanted organ, not the word "rejection", decides the CMS-HCC V28 category for payment year 2026.

T86.41 (Liver transplant rejection) is billable and maps to HCC 62 in CMS-HCC V28. The PY2026 V28 CSV row is `T8641,62.0,,,`. HCC 62 is titled Liver Transplant Status/Complications.

T86.4 (Complications of liver transplant) is a nonbillable heading in FY2027. It has no CSV row. Pick one of its five billable children. All five map to HCC 62.

The live HCC 62 hub shows a source-labeled community non-dual aged reference coefficient of 0.376 and 7 ICD rows: the five T86.4 leaves, Z94.4 (Liver transplant status), and Z48.23 (Encounter for aftercare following liver transplant). That is a category reference, not a member RAF total.

Every billable liver transplant complication leaf maps to HCC 62 in the PY2026 CSV:

• T86.40 Unspecified complication of liver transplant -> HCC 62
• T86.41 Liver transplant rejection -> HCC 62
• T86.42 Liver transplant failure -> HCC 62
• T86.43 Liver transplant infection -> HCC 62
• T86.49 Other complications of liver transplant -> HCC 62

The same rejection wording lands somewhere else when the organ changes:

• T86.11 Kidney transplant rejection -> billable, does not map (no CSV row). The same is true for T86.10, T86.12, T86.13, and T86.19. Z94.0 Kidney transplant status also has no CSV row.
• T86.21 Heart transplant rejection -> HCC 221 (Heart Transplant Status/Complications)
• T86.810 Lung transplant rejection -> HCC 276 (Lung Transplant Status/Complications)
• T86.850 Intestine transplant rejection -> HCC 77 (Intestine Transplant Status/Complications)

Rejection of a transplanted organ is not one HCC. The map is organ-specific and leaf-specific.

As of October 7, 2026, the public ICD leaf cards default to the FY2027 ICD-10-CM edition and read the V28 result from the CMS 2027 Initial ICD-10-CM Mappings (payment year 2027, 2026 dates of service). For every leaf in this desk, that card result agrees with the PY2026 V28 CSV and the live HCC hubs. Payment maps in this desk are verified from the PY2026 CSV and the hub listings.

This page is the coder-desk walk for the T86.41 liver transplant map under CMS-HCC V28.

Desk table: verified maps (2026-10-07)

Coeff refs are the live hub community non-dual aged references (HCC 62 0.376, HCC 221 1.053, HCC 276 2.531, HCC 77 1.172). Not member totals. Segment coefficients vary.

What T86.41 means on the claim

T86.41 is the liver transplant leaf for rejection. Use it when the provider documents rejection of the transplanted liver. It maps to HCC 62 when supported in the eligible year.

The other liver transplant leaves cover the rest of the subcategory: failure is T86.42, infection is T86.43, other documented complications are T86.49, and an unspecified complication is T86.40. All five map to HCC 62, but the leaf still has to match the record. Do not default every liver transplant problem to T86.41 or to T86.40 by habit.

Do not assign T86.41 because a pathology or lab report mentions rejection while the provider assessment says only "transplant follow up" or "abnormal liver tests". The provider has to document the complication and tie it to the transplanted liver. Query when the reports and the assessment disagree.

FY2027 Tabular notes coders ask about

These notes are shown on the live FY2027 cards with their source level:

• T80-T88 section note: code(s) to identify the specified condition resulting from the complication.
• T80-T88 section note: code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5).
• T86 category note: code to identify other transplant complications, such as graft-versus-host disease (D89.81-), malignancy associated with organ transplant (C80.2), and post-transplant lymphoproliferative disorders (PTLD) (D47.Z1).
• T86.43 note: code to identify infection, such as Cytomegalovirus (CMV) infection (B25.-).
• Z94 category Excludes1: complications of transplanted organ or tissue - see Alphabetical Index.
• Z94 category Includes: organ or tissue replaced by heterogenous or homogenous transplant.

The live T86.41 card shows no Code First note. The additional-code notes above are where the second code comes from. Code only the condition the provider documents. If the provider documents only "liver disease" with no type, K76.9 (Liver disease, unspecified) is billable but has no CSV row. T86.41 carries HCC 62 on its own.

The Z94 Excludes1 note is the status-versus-complication split. When the provider documents a liver transplant complication, the T86.4 leaf describes it. Do not add Z94.4 next to a T86.4 leaf for the same transplant.

The codes named in the T86 and T86.43 notes have their own maps in the PY2026 CSV:

• D89.810 Acute graft-versus-host disease and D89.811 Chronic graft-versus-host disease -> HCC 454 (Stem Cell, Including Bone Marrow, Transplant Status/Complications)
• C80.2 Malignant neoplasm associated with transplanted organ -> HCC 23 (Prostate, Breast, and Other Cancers and Tumors)
• D47.Z1 Post-transplant lymphoproliferative disorder (PTLD) -> HCC 21 (Lymphoma and Other Cancers)
• B25.9 Cytomegaloviral disease, unspecified -> HCC 6 (Opportunistic Infections)

Add one of these only when the provider documents that condition. They are not automatic companions to T86.41.

Coding paths (documentation-driven)

Pick the path from what the chart actually supports. Do not add a transplant complication, an organ, or a second condition for RAF.

1. Provider documents rejection of the transplanted liver -> T86.41 -> V28 HCC 62.

2. Provider documents failure of the transplanted liver -> T86.42 -> V28 HCC 62.

3. Provider documents infection of the transplanted liver -> T86.43 -> V28 HCC 62, plus a code for the documented infection per the T86.43 note.

4. Provider documents another named complication of the transplanted liver -> T86.49 -> V28 HCC 62, plus a code for the specified condition when documented.

5. Provider documents a liver transplant complication with no type -> T86.40 -> V28 HCC 62. Query for the type when the record supports one.

6. Provider documents a functioning liver transplant with no complication -> Z94.4 -> V28 HCC 62.

7. Encounter is for aftercare following liver transplant -> Z48.23 -> V28 HCC 62. It is an encounter reason, not a complication code.

8. Provider documents kidney transplant rejection -> T86.11 -> billable, no V28 map. Do not move it to a liver leaf.

9. Provider documents heart, lung, or intestine transplant rejection -> T86.21 (HCC 221), T86.810 (HCC 276), or T86.850 (HCC 77).

10. Never report T86.4 on a claim. It is a nonbillable heading.

11. Do not invent member RAF totals from the 0.376 reference.

Hierarchy note

The live HCC 62 hub shows HCC 62 superseding HCC 63, HCC 64, HCC 65, and HCC 68, with no category above it. The live hubs show:

• HCC 63 Chronic Liver Failure/End-Stage Liver Disorders, CNA reference 0.962, trumped by HCC 62. K72.10 Chronic hepatic failure without coma and K76.7 Hepatorenal syndrome map here.
• HCC 64 Cirrhosis of Liver, CNA reference 0.447, trumped by HCC 62 and HCC 63. K74.60 Unspecified cirrhosis of liver maps here.
• HCC 65 Chronic Hepatitis, CNA reference 0.185, trumped by HCC 62, HCC 63, and HCC 64. K73.9 Chronic hepatitis, unspecified maps here.
• HCC 68 Cholangitis and Obstruction of Bile Duct Without Gallstones, CNA reference 0.388, trumped by HCC 62, HCC 63, and HCC 64.

So when a supported HCC 62 code and a supported HCC 63, 64, 65, or 68 code are both on the record for the year, HCC 62 counts and the lower category drops. The HCC 63 reference (0.962) is higher than the HCC 62 reference (0.376), and the published hierarchy still puts HCC 62 on top. Hierarchy is applied by the model. It is not a reason to add or remove a documented diagnosis.

One more liver trap sits next to this cluster: K72.00 Acute and subacute hepatic failure without coma has no CSV row, while K72.10 chronic hepatic failure maps to HCC 63. Acute is not chronic.

MEAT for mapped HCC 62

In review, a liver transplant code is supported when the visit documents the transplant status or complication with a current assessment. A problem list line that says "liver transplant" from a prior year does not carry HCC 62 forward.

For mapped leaves in this desk, the note should support:

• M Monitor: symptoms, liver tests, drug levels, or surveillance status when documented
• E Evaluate: biopsy, imaging, or transplant clinic findings reviewed at the visit
• A Assess: an explicit statement of transplant status or of the complication (rejection, failure, infection, or other) tied to the transplanted liver
• T Treat: immunosuppression changes, antimicrobial therapy, a referral, or a documented surveillance plan

MEAT is a review mnemonic, not a universal CMS coding rule. Follow the applicable coding, encounter, program, and payer requirements. See MEAT, status Z codes that map, and problem lists.

Audit and query traps

1. Reporting T86.4 on a claim. It is a nonbillable heading with no CSV row. Use a T86.40 to T86.49 leaf.

2. Assuming every transplant rejection maps to HCC 62. Kidney transplant rejection T86.11 has no CSV row. Heart, lung, and intestine rejection map to HCC 221, 276, and 77.

3. Coding T86.40 when the provider documented rejection, failure, or infection. Use the specific leaf.

4. Coding T86.41 from a biopsy or lab report when the provider assessment does not state rejection.

5. Reporting Z94.4 next to a T86.4 leaf for the same transplant. The Z94 Excludes1 note lists complications of transplanted organ or tissue.

6. Using Z48.23 aftercare in place of a documented complication.

7. Skipping the second code the T86.43 note asks for when the provider documents the infection.

8. Adding D89.81-, C80.2, D47.Z1, or B25.- next to T86.41 without provider documentation of that condition.

9. Treating K76.9 liver disease, unspecified, or K72.00 acute hepatic failure as a mapped liver HCC. Neither has a CSV row.

10. Carrying a prior-year transplant line forward from a problem list with no current assessment.

11. Using the 0.376 CNA reference as a member RAF total.

12. Inventing Coding Clinic quotes, competitor CTAs, or PHI examples.

Related desks and tools

• Live cards: T86.41, T86.4, T86.40, T86.42, T86.43, T86.49, Z94.4, Z48.23, T86.11, Z94.0, K76.9
• Hubs: HCC 62, HCC 63, HCC 64, HCC 65
• Lookup: ICD-10 to HCC, Encoder
• Evidence habits: MEAT, acute vs history of, problem lists, hierarchy and trumping
• Nearby map/trap desks: status Z codes that map, C83.398 DLBCL, J69.0 aspiration pneumonia

Current as of October 7, 2026. Always confirm the PY2026 V28 CSV and the live HCC hub before you lock a map claim.