T86.8421 ICD-10-CM Code: Corneal transplant infection, right eye
T86.8421 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools
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FY 2026 Apr update / Injury, poisoning and certain other consequences of external causes (S00-T88) / Complications of surgical and medical care, not elsewhere classified (T80-T88)
T86.8421
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceCorneal transplant infection, right eye
An infection has developed in the cornea transplant of the right eye.
Buddy Insight
Corneal transplant infection in the right eye represents a serious ophthalmologic complication that can lead to graft failure and vision loss.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
MappedHCC 176
Code-level coefficient reference
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for T86.8421. Check the code and parent instructions in the Code Book.
Excludes 2
Official- birth trauma (P10-P15)Inherited from S00-T88, T80-T88, T86.84
- obstetric trauma (O70-O71)Inherited from S00-T88, T80-T88, T86.84
- any encounters with medical care for postprocedural conditions in which no complications are present, such as:Inherited from S00-T88, T80-T88, T86.84
- artificial opening status (Z93.-)Inherited from S00-T88, T80-T88, T86.84
- closure of external stoma (Z43.-)Inherited from S00-T88, T80-T88, T86.84
- fitting and adjustment of external prosthetic device (Z44.-)Inherited from S00-T88, T80-T88, T86.84
- burns and corrosions from local applications and irradiation (T20-T32)Inherited from S00-T88, T80-T88, T86.84
- complications of surgical procedures during pregnancy, childbirth and the puerperium (O00-O9A)Inherited from S00-T88, T80-T88, T86.84
- mechanical complication of respirator [ventilator] (J95.850)Inherited from S00-T88, T80-T88, T86.84
- poisoning and toxic effects of drugs and chemicals (T36-T65 with fifth or sixth character 1-4 or 6)Inherited from S00-T88, T80-T88, T86.84
- postprocedural fever (R50.82)Inherited from S00-T88, T80-T88, T86.84
- specified complications classified elsewhere, such as:Inherited from S00-T88, T80-T88, T86.84
- cerebrospinal fluid leak from spinal puncture (G97.0)Inherited from S00-T88, T80-T88, T86.84
- colostomy malfunction (K94.0-)Inherited from S00-T88, T80-T88, T86.84
- disorders of fluid and electrolyte imbalance (E86-E87)Inherited from S00-T88, T80-T88, T86.84
- functional disturbances following cardiac surgery (I97.0-I97.1)Inherited from S00-T88, T80-T88, T86.84
- intraoperative and postprocedural complications of specified body systems (D78.-, E36.-, E89.-, G97.3-, G97.4, H59.3-, H59.-, H95.2-, H95.3, I97.4-, I97.5, J95.6-, J95.7, K91.6-, L76.-, M96.-, N99.-)Inherited from S00-T88, T80-T88, T86.84
- ostomy complications (J95.0-, K94.-, N99.5-)Inherited from S00-T88, T80-T88, T86.84
- postgastric surgery syndromes (K91.1)Inherited from S00-T88, T80-T88, T86.84
- postlaminectomy syndrome NEC (M96.1)Inherited from S00-T88, T80-T88, T86.84
- postmastectomy lymphedema syndrome (I97.2)Inherited from S00-T88, T80-T88, T86.84
- postsurgical blind-loop syndrome (K91.2)Inherited from S00-T88, T80-T88, T86.84
- ventilator associated pneumonia (J95.851)Inherited from S00-T88, T80-T88, T86.84
- mechanical complications of corneal graft (T85.3-)Inherited from S00-T88, T80-T88, T86.84
Related Codes
Includes
OfficialNo Includes notes are included in this display for T86.8421. Check the code and parent instructions in the Code Book.
Excludes 1
OfficialNo Excludes 1 notes are included in this display for T86.8421. Check the code and parent instructions in the Code Book.
Code First
OfficialNo Code First sequencing instructions are included in this display for T86.8421. Check the code and parent instructions in the Code Book.
Use Additional
Official- code to identify any retained foreign body, if applicable (Z18.-)Inherited from S00-T88, T80-T88, T86, T86.842
- code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)Inherited from S00-T88, T80-T88, T86, T86.842
- code(s) to identify the specified condition resulting from the complicationInherited from S00-T88, T80-T88, T86, T86.842
- code to identify devices involved and details of circumstances (Y62-Y82)Inherited from S00-T88, T80-T88, T86, T86.842
- code to identify other transplant complications, such as:Inherited from S00-T88, T80-T88, T86, T86.842
- graft-versus-host disease (D89.81-)Inherited from S00-T88, T80-T88, T86, T86.842
- malignancy associated with organ transplant (C80.2)Inherited from S00-T88, T80-T88, T86, T86.842
- post-transplant lymphoproliferative disorders (PTLD) (D47.Z1)Inherited from S00-T88, T80-T88, T86, T86.842
- code to specify infectionInherited from S00-T88, T80-T88, T86, T86.842
Code Also
OfficialNo Code Also instructions are included in this display for T86.8421. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is T86.8421 an HCC code?
T86.8421 has no mapping under the current CMS-HCC V28 community payment model. T86.8421 has a separate mapping under the CMS-HCC ESRD model (HCC 176 (Complications of Specified Implanted Device or Graft)); the applicable result needs member context.
- Code
- T86.8421
- Description
- Corneal transplant infection, right eye
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.
Work T86.8421 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for T86.8421
For T86.8421, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Coder workflow notes
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What This Code Means
T86.8421 is the ICD-10-CM diagnosis code for corneal transplant infection, right eye. An infection has developed in the cornea transplant of the right eye. T86.8421 sits in the ICD-10-CM chapter for injury, poisoning and certain other consequences of external causes (s00-t88), within the section covering complications of surgical and medical care, not elsewhere classified (t80-t88).
T86.8421 has no mapping under the current CMS-HCC V28 community payment model. T86.8421 has a separate mapping under the CMS-HCC ESRD model (HCC 176 (Complications of Specified Implanted Device or Graft)); the applicable result needs member context. Do not assign V28 risk adjustment value from this page; verify the applicable model and payment year before using this code for risk adjustment.
Use this code when infection is documented as a complication of corneal transplant in the right eye.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for T86.8421 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code when infection is documented as a complication of corneal transplant in the right eye
- •Consider assigning an additional code to specify the type of infection if documented (bacterial, fungal, viral)
Clinical Significance
Corneal transplant infection in the right eye represents a serious ophthalmologic complication that can lead to graft failure and vision loss. These infections require prompt recognition and aggressive treatment to preserve vision and graft function.
Documentation Requirements
- ✓Documentation of corneal transplant procedure in right eye with date
- ✓Clinical evidence of infection (conjunctival injection, purulent discharge, corneal infiltrate)
- ✓Ophthalmologic examination findings supporting infection
- ✓Culture results or microbiologic studies when available
- ✓Visual acuity measurements and changes
- ✓Treatment with topical or systemic antimicrobials
- ✓Laterality clearly specified as right eye
- ✓Provider assessment confirming transplant-related infection
Commonly Confused Codes
- •H16.9: keratitis unspecified (transplant-related vs non-transplant keratitis)
- •T86.8422: corneal transplant infection, left eye (right vs left eye)
- •T86.8429: corneal transplant infection, unspecified eye (specified vs unspecified laterality)
- •H05.00: acute inflammation of orbit unspecified (corneal vs orbital infection)
- •Z94.7: corneal transplant status (infection vs stable status)