ICD-10 D86.0
Billable / Specific HCC v28: 112Sarcoidosis of lung
About ICD-10-CM D86.0
ICD-10-CM code D86.0 represents Sarcoidosis of lung. This is a billable/specific code in the Blood and Blood-forming Organs chapter (block D86). The 2026 edition of ICD-10-CM D86.0 became effective on October 1, 2025.
Coding Tips for D86.0
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
D86.0 is a CMS-HCC v28 risk-adjustment code (category 112). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Medicare LCD Coverage for D86.0
Local Coverage Determinations (LCDs) from CMS MACs that list D86.0 as a covered diagnosis.
Showing top 10 of 315 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing D86.0.
1 Aetna
2 Cigna
5 Medicare
CPT Codes Commonly Billed with D86.0
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- Q9957 CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE) CMS LCD
- Q9955 CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE) CMS LCD
- C8923 CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE) CMS LCD
- C8928 CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE) CMS LCD
- C8924 CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE) CMS LCD
- C8921 CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE) CMS LCD
- 76376 CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE) CMS LCD
- C8930 CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE) CMS LCD
- C8929 CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE) CMS LCD
- C8922 CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE) CMS LCD
Convert D86.0 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| D86.0 | 135 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To D86.0
Other codes in section D80-D89 (Certain disorders involving the immune mechanism).
ICD-10 D86.0, Billing FAQ
Is ICD-10 code D86.0 billable? +
Yes, D86.0 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does D86.0 affect Medicare Advantage HCC risk adjustment? +
Yes. D86.0 maps to CMS-HCC v28 category 112. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What CPT codes are commonly billed with D86.0? +
Procedures frequently paired with D86.0 include: Q9957, Q9955, C8923, C8928, C8924.
What ICD-9 codes does D86.0 map to? +
Per CMS GEMs, D86.0 maps to ICD-9 codes: 135. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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