T86.22
BillableHeart transplant failure
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
A transplanted heart loses its ability to pump blood effectively due to various complications.
Coding Tips
- •Determine the underlying cause (rejection, infection, vasculopathy) and code accordingly if documented
- •Document ejection fraction or other cardiac function parameters to support the diagnosis
Clinical Significance
Heart transplant failure represents catastrophic graft loss requiring emergency mechanical support or re-transplantation, with extremely high mortality risk without immediate intervention. This complication necessitates intensive care management and consideration of advanced therapies including ventricular assist devices or emergency re-transplantation.
Documentation Requirements
- ✓History of heart transplant with transplant date
- ✓Evidence of graft failure (severe dysfunction, cardiogenic shock)
- ✓Hemodynamic instability and cardiac output measurements
- ✓Precipitating factors (rejection, vasculopathy, infection)
- ✓Need for mechanical circulatory support or inotropic therapy
- ✓Evaluation for re-transplantation candidacy
- ✓End-of-life planning discussions when appropriate
- ✓Multidisciplinary team involvement and care goals
Commonly Confused Codes
T86.21 — Heart transplant rejection (active process vs end-stage failure)T86.20 — Unspecified heart transplant complication (when failure documented)I50.9 — Heart failure (general vs transplant-specific failure)T86.290 — Cardiac allograft vasculopathy (cause vs consequence)Z99.0 — Dependence on aspirator/respirator (supportive care measure)
Code Hierarchy
└T86Complications of transplanted organs and tissue└T86.2Complications of heart transplant└T86.22Heart transplant failure
└T86.22Heart transplant failure