D47.Z1

Billable

Post-transplant lymphoproliferative disorder (PTLD)

HCC Category Mapping

V28HCC 21 — Breast, Prostate, Colorectal and Other Cancers and Tumors

0.545

V24HCC 48 — Coagulation Defects and Other Specified Hematological Disorders

0.209

ESRDHCC 48 — Coagulation Defects and Other Specified Hematological Disorders

0.000

What This Code Means

An abnormal growth of lymphoid cells that develops after an organ or tissue transplant due to weakened immune function.

Coding Tips

•Always link this diagnosis to a transplant procedure; document the type of transplant (bone marrow, solid organ, etc.)
•Include the timeframe of PTLD development relative to transplant date in clinical documentation

Clinical Significance

Post-transplant lymphoproliferative disorder is a potentially life-threatening complication of solid organ or hematopoietic stem cell transplantation, resulting from uncontrolled lymphoid proliferation due to immunosuppression. The spectrum ranges from benign polyclonal hyperplasia to aggressive monoclonal lymphoma, and it is frequently associated with Epstein-Barr virus reactivation in the immunosuppressed host.

Documentation Requirements

✓Documentation must link the lymphoproliferative disorder to a prior transplant, specifying the type of transplant (kidney, liver, heart, lung, bone marrow) and timing of onset relative to transplantation.
✓Tissue biopsy confirming lymphoid proliferation is required.
✓Epstein-Barr virus status (viral load, in situ hybridization), immunosuppression regimen, and pathologic subtype (early lesion, polymorphic, monomorphic) should be documented.

Code First

complications of transplanted organs and tissue (T86.-)

Commonly Confused Codes

C83-C85 (non-Hodgkin lymphoma codes) may be used for monomorphic post-transplant lymphoproliferative disorder that meets criteria for a specific lymphoma subtype.D47.9 (uncertain behavior of lymphoid/hematopoietic tissue, unspecified) is less specific.T86.x codes should be used additionally to identify the type of transplant and any graft complications.

Code Hierarchy

└D47Other neoplasms of uncertain behavior of lymphoid, hematopoietic and related tissue └D47.ZOther specified neoplasms of uncertain behavior of lymphoid, hematopoietic and related tissue └D47.Z1Post-transplant lymphoproliferative disorder (PTLD)

└D47.Z1Post-transplant lymphoproliferative disorder (PTLD)