T86.811
BillableLung transplant failure
HCC Category Mapping
V28HCC 276 — Lung Transplant Status/Complications
0.193V24HCC 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 lung stops functioning properly or fails to work as expected after transplantation.
Coding Tips
- •Differentiate between primary graft failure (occurs immediately) and secondary graft failure (occurs later)
- •Document the clinical evidence of lung failure such as decreased function, need for re-transplant, or mechanical support
Clinical Significance
Lung transplant failure indicates severe graft dysfunction regardless of cause, representing a life-threatening condition requiring intensive management and possible retransplantation consideration. This diagnosis carries significant mortality risk and healthcare resource utilization implications.
Documentation Requirements
- ✓Documentation of previous lung transplant with procedure date
- ✓Evidence of graft failure (pulmonary function tests, imaging studies, biopsy)
- ✓Clinical manifestations of failure (severe dyspnea, hypoxemia, respiratory failure)
- ✓Exclusion or identification of reversible causes
- ✓Arterial blood gas results demonstrating respiratory compromise
- ✓Chest imaging showing graft dysfunction
- ✓Provider assessment confirming transplant failure
- ✓Current management plan including consideration for retransplantation
Commonly Confused Codes
T86.810 — lung transplant rejection (failure vs specific rejection mechanism)T86.812 — lung transplant infection (failure vs infectious complication)J96.90 — respiratory failure unspecified (transplant-related vs non-transplant respiratory failure)Z94.2 — lung transplant status (failure vs stable transplant status)T86.818 — other lung transplant complications (failure vs other specific complications)