T86.290
BillableCardiac allograft vasculopathy
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
Blood vessels in a transplanted heart develop narrowing and hardening (similar to atherosclerosis), reducing blood flow to the organ.
Coding Tips
- •This is a chronic complication that may develop months to years after transplantation
- •Document the severity and location of vasculopathy when available in imaging or catheterization reports
Clinical Significance
Cardiac allograft vasculopathy represents chronic rejection manifesting as accelerated coronary artery disease in the transplanted heart, leading to ischemia and eventual graft failure. This complication requires specialized monitoring with annual coronary angiography and may necessitate interventional procedures or re-transplantation for survival.
Documentation Requirements
- ✓History of heart transplant with transplant date
- ✓Coronary angiography findings showing vasculopathy
- ✓Clinical symptoms of ischemia or heart failure
- ✓Echocardiographic evidence of cardiac dysfunction
- ✓Time interval from transplant to vasculopathy development
- ✓Interventional procedures performed (angioplasty, stenting)
- ✓Medical management including antiplatelet therapy
- ✓Evaluation for re-transplantation candidacy
Commonly Confused Codes
I25.10 — Atherosclerotic heart disease (native vessel disease)T86.21 — Heart transplant rejection (acute vs chronic process)T86.298 — Other heart transplant complications (when vasculopathy documented)I25.700 — Atherosclerosis of coronary artery bypass graftT86.22 — Heart transplant failure (consequence vs specific pathology)