T86.32
BillableHeart-lung transplant failure
HCC Category Mapping
V24HCC 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 transplanted heart and lungs stop functioning properly or cease to work after transplantation.
Coding Tips
- •Distinguish between primary graft failure (immediate) and secondary graft failure (delayed); document timing when possible
- •This code indicates organ dysfunction; coordinate with cardiology and pulmonology documentation
Clinical Significance
Heart-lung transplant failure represents catastrophic loss of both organs with extremely poor prognosis and limited treatment options, as re-transplantation of both organs is rarely feasible. This complication requires intensive supportive care and often involves end-of-life planning due to the complexity and scarcity of suitable donor organs.
Documentation Requirements
- ✓History of heart-lung transplant with transplant date
- ✓Evidence of failure in heart, lungs, or both organs
- ✓Hemodynamic instability and respiratory failure
- ✓Precipitating factors leading to dual organ failure
- ✓Need for mechanical circulatory and/or respiratory support
- ✓Evaluation for feasibility of re-transplantation
- ✓Family discussions regarding prognosis and care goals
- ✓Multidisciplinary team coordination for complex care needs
Commonly Confused Codes
T86.31 — Heart-lung transplant rejection (active process vs end-stage failure)T86.30 — Unspecified heart-lung transplant complication (when failure documented)T86.22 — Heart transplant failure (single organ vs combined)T86.812 — Lung transplant failure (single organ vs combined)R09.2 — Respiratory arrest (symptom vs transplant-specific failure)
Code Hierarchy
└T86Complications of transplanted organs and tissue└T86.3Complications of heart-lung transplant└T86.32Heart-lung transplant failure
└T86.32Heart-lung transplant failure