T86.21
BillableHeart transplant rejection
HCC Category Mapping
V28HCC 221 — Heart Transplant Status/Complications
0.910V24HCC 186 — Major Organ Transplant or Replacement Status
0.910ESRDHCC 186 — Major Organ Transplant or Replacement Status
0.000RxHCCHCC 396 — Allograft Complications
0.000What This Code Means
The recipient's immune system attacks and rejects a transplanted heart, causing it to malfunction.
Coding Tips
- •Document whether rejection is hyperacute, acute, or chronic when available
- •Correlate with clinical findings such as decreased cardiac function or hemodynamic changes
Clinical Significance
Heart transplant rejection represents a life-threatening complication requiring immediate aggressive immunosuppressive therapy to prevent graft loss and death. Early detection through routine surveillance biopsies and prompt treatment with anti-rejection protocols are critical for preserving cardiac function and patient survival.
Documentation Requirements
- ✓History of heart transplant with transplant date
- ✓Evidence of rejection from endomyocardial biopsy or clinical presentation
- ✓Grade and type of rejection (cellular vs antibody-mediated)
- ✓Clinical symptoms (dyspnea, fatigue, arrhythmias)
- ✓Diagnostic studies including echocardiogram and right heart catheterization
- ✓Anti-rejection therapy administered
- ✓Response to treatment and follow-up biopsy results
- ✓Transplant team management and adjustments to immunosuppression
Commonly Confused Codes
T86.20 — Unspecified heart transplant complication (when rejection documented)T86.22 — Heart transplant failure (end result vs active rejection)T86.290 — Cardiac allograft vasculopathy (different pathophysiology)I50.9 — Heart failure (symptom vs transplant-specific complication)Z94.1 — Heart transplant status (for stable patients without rejection)
Code Hierarchy
└T86Complications of transplanted organs and tissue└T86.2Complications of heart transplant└T86.21Heart transplant rejection
└T86.21Heart transplant rejection