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D89.811 ICD-10-CM Code: Chronic graft-versus-host disease

D89.811 maps to CMS-HCC V28 454. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC Buddy coding tools

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Code lookupD89.811

FY 2026 Apr update / Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89) / Certain disorders involving the immune mechanism (D80-D89)

D89.811

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Chronic graft-versus-host disease

A long-term complication of bone marrow or stem cell transplant where the donor's immune cells continue to attack the recipient's body tissues months to years after transplant.

Buddy the Bee presenting code insight

Buddy Insight

Chronic graft-versus-host disease is a multisystem fibroinflammatory and immune-mediated condition that typically develops more than 100 days after allogeneic stem cell transplantation, though it can occur earlier.

OverviewRisk ModelsCode BookDocumentationAuditNotesEdition comparison

CMS-HCC V28

HCC 454

Coefficient HCC 454: 1.068 (Community Non-Dual Aged (CNA))

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

HCC 251

Code-level coefficient reference

ESRD/PACE

HCC 47

Code-level coefficient reference

RXHCC

HCC 395

Code-level coefficient reference

Code Book Path

Official
D89.8Other specified disorders involving the immune mechanism, not elsewhere classifiedD89.81Graft-versus-host diseaseD89.811Chronic graft-versus-host disease

Inclusion Terms

Official

No inclusion terms are included in this display for D89.811. Check the code and parent instructions in the Code Book.

Excludes 2

Official
  • autoimmune disease (systemic) NOS (M35.9)Inherited from D50-D89, D89
  • certain conditions originating in the perinatal period (P00-P96)Inherited from D50-D89, D89
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from D50-D89, D89
  • congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)Inherited from D50-D89, D89
  • endocrine, nutritional and metabolic diseases (E00-E88)Inherited from D50-D89, D89
  • human immunodeficiency virus [HIV] disease (B20)Inherited from D50-D89, D89
  • injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from D50-D89, D89
  • neoplasms (C00-D49)Inherited from D50-D89, D89
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from D50-D89, D89
  • transplant failure and rejection (T86.-)Inherited from D50-D89, D89

Related Codes

Official
D89.810Acute graft-versus-host diseaseD89.812Acute on chronic graft-versus-host diseaseD89.813Graft-versus-host disease, unspecified

Includes

Official
  • defects in the complement systemInherited from D80-D89
  • immunodeficiency disorders, except human immunodeficiency virus [HIV] diseaseInherited from D80-D89
  • sarcoidosisInherited from D80-D89

Excludes 1

Official
  • autoimmune disease (systemic) NOS (M35.9)Inherited from D80-D89, D89
  • functional disorders of polymorphonuclear neutrophils (D71-)Inherited from D80-D89, D89
  • human immunodeficiency virus [HIV] disease (B20)Inherited from D80-D89, D89
  • hyperglobulinemia NOS (R77.1)Inherited from D80-D89, D89
  • monoclonal gammopathy (of undetermined significance) (D47.2)Inherited from D80-D89, D89

Code First

Official
  • underlying cause, such as:Inherited from D89.81
  • complications of transplanted organs and tissue (T86.-)Inherited from D89.81
  • complications of blood transfusion (T80.89)Inherited from D89.81

Use Additional

Official
  • code to identify associated manifestations, such as:Inherited from D89.81
  • desquamative dermatitis (L30.8)Inherited from D89.81
  • diarrhea (R19.7)Inherited from D89.81
  • elevated bilirubin (R17)Inherited from D89.81
  • hair loss (L65.9)Inherited from D89.81

Code Also

Official

No Code Also instructions are included in this display for D89.811. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance
Documentation should specify chronic graft-versus-host disease with the organ systems affected, NIH consensus severity grading (mild, moderate, severe), and whether it is limited or extensive.
The relationship to prior stem cell transplant must be established.
Current immunosuppressive regimen, functional status, and any organ-specific complications (pulmonary function decline, ocular damage) should be recorded.

MEAT Support

HCC Buddy guidance
Documentation should specify chronic graft-versus-host disease with the organ systems affected, NIH consensus severity grading (mild, moderate, severe), and whether it is limited or extensive.
The relationship to prior stem cell transplant must be established.
Current immunosuppressive regimen, functional status, and any organ-specific complications (pulmonary function decline, ocular damage) should be recorded.

Audit Caution

HCC Buddy guidance
Do not assign this code based solely on timing post-transplant
chronic graft-versus-host disease requires specific diagnostic features (skin sclerosis, bronchiolitis obliterans, etc.) distinct from acute presentations. Ensure concurrent transplant status code (Z94.84) is assigned. Do not use unspecified code D89.813 when the chronic form is clearly documented. Multiple organ-specific manifestations may require additional codes.

Common Mistakes

HCC Buddy guidance
D89.810 (Acute graft-versus-host disease) presents with different clinical features and typically occurs earlier. D89.812 (Acute on chronic graft-versus-host disease) captures the overlap syndrome. D89.813 (Graft-versus-host disease, unspecified) should be avoided when chronic form is documented. M35.0
(Sicca syndrome/Sjogren) may overlap clinically but has a different etiology.

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is D89.811 an HCC code?

Yes. D89.811 (Chronic graft-versus-host disease) maps to HCC 454, Stem Cell, Including Bone Marrow, Transplant Status/Complications under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 1.068. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.

Coder answer: D89.811 is billable and maps to V28 HCC 454, Stem Cell, Including Bone Marrow, Transplant Status/Complications. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code
D89.811
Description
Chronic graft-versus-host disease
HCC (V28)
HCC 454 — Stem Cell, Including Bone Marrow, Transplant Status/Complications
RAF reference coefficient
1.068
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 454, Stem Cell, Including Bone Marrow, Transplant Status/Complications
1.068
ESRDHCC 47, Disorders of Immunity
Not separately weighted
RxHCCHCC 395, Stem Cell, Including Bone Marrow, Transplant Status/Complications
Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work D89.811 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for D89.811

For D89.811, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

  • MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
  • EEvaluate: test results, medication response, or physical findings reviewed by the provider
  • AAssess: explicit mention in the assessment or plan with acknowledgment of status
  • TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Coder workflow notes

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What This Code Means

D89.811 is the ICD-10-CM diagnosis code for chronic graft-versus-host disease. A long-term complication of bone marrow or stem cell transplant where the donor's immune cells continue to attack the recipient's body tissues months to years after transplant. D89.811 sits in the ICD-10-CM chapter for diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (d50-d89), within the section covering certain disorders involving the immune mechanism (d80-d89).

Under the CMS-HCC V28 risk adjustment model, D89.811 maps to Stem Cell, Including Bone Marrow, Transplant Status/Complications (HCC 454) with a source-labeled community, non-dual, aged reference coefficient of 1.068. No V24 mapping is shown for D89.811; use the applicable model and payment year when reviewing the V28 mapping. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

Document the onset (typically after 100 days post-transplant) and specific organs involved. For D89.811, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for D89.811 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •Document the onset (typically after 100 days post-transplant) and specific organs involved
  • •Differentiate from acute GVHD by timing and clinical presentation

Clinical Significance

Chronic graft-versus-host disease is a multisystem fibroinflammatory and immune-mediated condition that typically develops more than 100 days after allogeneic stem cell transplantation, though it can occur earlier. It affects the skin (sclerosis, lichen planus-like changes), eyes (sicca syndrome), oral mucosa, lungs (bronchiolitis obliterans), liver, and gastrointestinal tract. It is the leading cause of late non-relapse mortality and long-term morbidity in transplant survivors.

Documentation Requirements

  • ✓Documentation should specify chronic graft-versus-host disease with the organ systems affected, NIH consensus severity grading (mild, moderate, severe), and whether it is limited or extensive.
  • ✓The relationship to prior stem cell transplant must be established.
  • ✓Current immunosuppressive regimen, functional status, and any organ-specific complications (pulmonary function decline, ocular damage) should be recorded.

Commonly Confused Codes

  • •D89.810 (Acute graft-versus-host disease) presents with different clinical features and typically occurs earlier. D89.812 (Acute on chronic graft-versus-host disease) captures the overlap syndrome. D89.813 (Graft-versus-host disease, unspecified) should be avoided when chronic form is documented. M35.0
  • •(Sicca syndrome/Sjogren) may overlap clinically but has a different etiology.

Child Codes

D89.810Acute graft-versus-host disease
HCC 454
D89.811Chronic graft-versus-host disease
HCC 454
D89.812Acute on chronic graft-versus-host disease
HCC 454
D89.813Graft-versus-host disease, unspecified
HCC 454

Code Hierarchy

└D89Other disorders involving the immune mechanism, not elsewhere classified└D89.8Other specified disorders involving the immune mechanism, not elsewhere classified└D89.81Graft-versus-host disease└D89.811Chronic graft-versus-host disease
└D89.811Chronic graft-versus-host disease

Also searched as

  • D89 811
  • D89811

For D89.811, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

D89.811 maps to CMS-HCC V28 category 454, Stem Cell, Including Bone Marrow, Transplant Status/Complications. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. The mapping identifies a payment HCC category for D89.811. Review its source-labeled HCC coefficient above, check the RAF Calculator with complete member context for CMS-HCC V28 PY2026, and confirm the documentation the chart needs before the code is submitted. HCC Buddy shows no RAF score unless every required source and calculation check passes.

More on D89.811

Referenced in blog posts

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