ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 T86.33

Billable / Specific CC

Heart-lung transplant infection

T86
Block
0
Synonyms
947
LCDs
29
Payer Policies
0
Linked CPTs

About ICD-10-CM T86.33

ICD-10-CM code T86.33 represents Heart-lung transplant infection. This is a billable/specific code in the Injury, Poisoning, and External Causes chapter (block T86). The 2026 edition of ICD-10-CM T86.33 became effective on October 1, 2025.

Coding Tips for T86.33

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

Inpatient DRG impact: CC

T86.33 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

Injury chapter (S00-T88): 7th character extension required

Injury codes require a 7th character: A (initial encounter, active treatment), D (subsequent, healing/recovery), S (sequela, late effect of original injury). Codes with fewer than 6 characters need the placeholder X to bring them to 6 characters before adding the 7th. Wrong or missing 7th character is the #1 cause of injury claim denials.

Use Additional Code

When coding T86.33, also report these additional codes when applicable.

  • code to specify infection

Inpatient DRG Impact, CC

codes Heart-lung transplant infection. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for T86.33

Local Coverage Determinations (LCDs) from CMS MACs that list T86.33 as a covered diagnosis.

947 LCDs

Showing top 10 of 947 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Cardiac Radionuclide Imaging
Article ID: 56476, Effective: 2025-10-01 00:00:00, 627 covered, 0 non-covered
CPT A4641 →
CMS LCD: Billing and Coding: Cardiac Radionuclide Imaging
Article ID: 56476, Effective: 2025-10-01 00:00:00, 627 covered, 0 non-covered
CPT J0461 →
CMS LCD: Billing and Coding: Cardiac Radionuclide Imaging
Article ID: 56476, Effective: 2025-10-01 00:00:00, 627 covered, 0 non-covered
CPT A9611 →
CMS LCD: Billing and Coding: Cardiac Radionuclide Imaging
Article ID: 56476, Effective: 2025-10-01 00:00:00, 627 covered, 0 non-covered
CPT 78454 →
CMS LCD: Billing and Coding: Cardiac Radionuclide Imaging
Article ID: 56476, Effective: 2025-10-01 00:00:00, 627 covered, 0 non-covered
CPT J1245 →
CMS LCD: Billing and Coding: Cardiac Radionuclide Imaging
Article ID: 56476, Effective: 2025-10-01 00:00:00, 627 covered, 0 non-covered
CPT 78453 →
CMS LCD: Billing and Coding: Cardiac Radionuclide Imaging
Article ID: 56476, Effective: 2025-10-01 00:00:00, 627 covered, 0 non-covered
CPT A9500 →
CMS LCD: Billing and Coding: Cardiac Radionuclide Imaging
Article ID: 56476, Effective: 2025-10-01 00:00:00, 627 covered, 0 non-covered
CPT J0280 →
CMS LCD: Billing and Coding: Cardiac Radionuclide Imaging
Article ID: 56476, Effective: 2025-10-01 00:00:00, 627 covered, 0 non-covered
CPT J1250 →
CMS LCD: Billing and Coding: Cardiac Radionuclide Imaging
Article ID: 56476, Effective: 2025-10-01 00:00:00, 627 covered, 0 non-covered
CPT A9501 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing T86.33.

29 policies

1 Cigna

Nucleic Acid Pathogen Testing - (0530)
Policy ID: MM_0530

5 Medicare

Nebulizers - Policy Article
Policy ID: ART-52466
Immunosuppressive Drugs - Policy Article
Policy ID: ART-52474
Billing and Coding: Cardiac Catheterization and Coronary Angiography
Policy ID: ART-52850
Billing and Coding: Lab: Flow Cytometry
Policy ID: ART-55717
Billing and Coding: Assays for Vitamins and Metabolic Function
Policy ID: ART-56416

CPT Codes Commonly Billed with T86.33

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for T86.33

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Convert T86.33 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
T86.33 99683 10111
T86.33 99684 10112

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

Codes Adjacent To T86.33

Other codes in section T80-T88 (Complications of surgical and medical care, not elsewhere classified).

T80 Complications following infusion, transfusion and therapeutic injection (non-billable) T80.0 Air embolism following infusion, transfusion and therapeutic injection (non-billable) T80.1 Vascular complications following infusion, transfusion and therapeutic injection (non-billable) T80.2 Infections following infusion, transfusion and therapeutic injection (non-billable) T80.21 Infection due to central venous catheter (non-billable) T80.211 Bloodstream infection due to central venous catheter (non-billable) T80.212 Local infection due to central venous catheter (non-billable) T80.218 Other infection due to central venous catheter (non-billable) T80.219 Unspecified infection due to central venous catheter (non-billable) T80.22 Acute infection following transfusion, infusion, or injection of blood and blood products (non-billable) T80.29 Infection following other infusion, transfusion and therapeutic injection (non-billable) T80.3 ABO incompatibility reaction due to transfusion of blood or blood products (non-billable) T80.30 ABO incompatibility reaction due to transfusion of blood or blood products, unspecified (non-billable) T80.31 ABO incompatibility with hemolytic transfusion reaction (non-billable) T80.310 ABO incompatibility with acute hemolytic transfusion reaction (non-billable) T80.311 ABO incompatibility with delayed hemolytic transfusion reaction (non-billable) T80.319 ABO incompatibility with hemolytic transfusion reaction, unspecified (non-billable) T80.39 Other ABO incompatibility reaction due to transfusion of blood or blood products (non-billable) T80.4 Rh incompatibility reaction due to transfusion of blood or blood products (non-billable) T80.40 Rh incompatibility reaction due to transfusion of blood or blood products, unspecified (non-billable)

ICD-10 T86.33, Billing FAQ

Is ICD-10 code T86.33 billable? +

Yes, T86.33 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Is T86.33 a CC or MCC for inpatient DRG? +

Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.

What ICD-9 codes does T86.33 map to? +

Per CMS GEMs, T86.33 maps to ICD-9 codes: 99683, 99684. Useful for legacy data review and historical claim analysis.

Get the full PayerReady toolkit

Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.

Start free →

Run this code through our claim audit tool

Check NCCI bundling, MUE limits, and modifier logic before submission.

Try the auditor →

Did this page help?

Quick signal so we know what to improve.

Thanks!

If you want a code reference page that doesn't exist yet, email coding@payerready.com.

Sorry to hear that.

Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.

Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team

Faster Approvals

Ready to Cut Your Enrollment Timeline in Half?

Join providers in all 50 states who handed off credentialing to a dedicated specialist. Create your free account in minutes and start enrolling the same day.

All 50 States Covered
No Long-Term Contracts
HIPAA HIPAA Compliant Platform
Dedicated Specialist Included