T86.12

Billable

Kidney transplant failure

HCC Category Mapping

RxHCCHCC 260 — Kidney Transplant Complications

0.000

What This Code Means

A transplanted kidney loses its ability to function, which may result from rejection, infection, or other complications.

Coding Tips

•Verify whether failure is due to rejection (T86.11), infection (T86.13), or other causes before coding
•Document the timeline and clinical presentation to support medical necessity

Clinical Significance

Kidney transplant failure represents loss of graft function requiring return to dialysis or re-transplantation, indicating severe patient morbidity and substantial healthcare resource utilization. This complication often results from untreated rejection, chronic damage, or other irreversible causes affecting long-term patient outcomes.

Documentation Requirements

✓History of kidney transplant with transplant date
✓Evidence of graft failure (severely elevated creatinine, anuria)
✓Clinical course leading to failure (rejection, infection, ischemia)
✓Laboratory confirmation of non-functional transplant
✓Initiation of dialysis or transplant evaluation
✓Immunosuppression discontinuation or modification
✓Transplant team assessment and recommendations
✓Patient counseling regarding treatment options

Commonly Confused Codes

T86.11 — Kidney transplant rejection (active process vs end result)T86.10 — Unspecified kidney transplant complication (when failure is documented)N18.6 — End stage renal disease (may be used concurrently)Z99.2 — Dependence on renal dialysis (when dialysis restarted)Z94.0 — Kidney transplant status (inappropriate for failed transplant)

Code Hierarchy

└T86Complications of transplanted organs and tissue └T86.1Complications of kidney transplant └T86.12Kidney transplant failure

└T86.12Kidney transplant failure