D89.811
BillableChronic graft-versus-host disease
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is D89.811 an HCC code?
Yes. D89.811 maps to Graft-Versus-Host Disease and Stem Cell Transplant Complications under the CMS-HCC V28 risk adjustment model (and Disorders of Immunity under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
MEAT Criteria for D89.811
For D89.811 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically — it has to be re-documented and supported each calendar year.
- 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
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed D89.811 during that encounter — not just copy-forwarded from a problem list.
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 Graft-Versus-Host Disease and Stem Cell Transplant Complications (HCC 454) with a community, non-dual, aged base RAF weight of 0.000. Under the older CMS-HCC V24 model, D89.811 maps to Disorders of Immunity (HCC 47) with a community, non-dual, aged base RAF weight of 0.472. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
Document the onset (typically after 100 days post-transplant) and specific organs involved. Because D89.811 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. 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, RAF weights, 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.