2027 ICD-10-CM Diagnosis Code D47.Z1Post-transplant lymphoproliferative disorder (PTLD)
ICD-10-CM Codes›C00–D49›D37-D48›D47
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Risk Adjusts — HCC 21
- Not a Principal Diagnosis
- Chronic Condition
D47.Z1 is a billable ICD-10-CM diagnosis code for post-transplant lymphoproliferative disorder (PTLD). It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 919 through 921. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 52 closely related codes. The code is not accepted as a principal diagnosis by the Medicare Code Editor. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Neoplasms of unspecified nature or uncertain behavior.
For Medicare Advantage risk adjustment, D47.Z1 maps to CMS-HCC Category 21 (Lymphoma and Other Cancers) under the V28 model, adding a risk factor of about 0.671 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for D47.Z1.
Medicare Risk Adjustment (HCC)Billing
D47.Z1 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.
Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Early post-transplant lymphoproliferative disorder
- Iatrogenic immunodeficiency-associated lymphoproliferative disorder
- Infectious mononucleosis-like post-transplant lymphoproliferative disorder
- Lymphoproliferative disorder after transplantation of bone marrow
- Lymphoproliferative disorder following heart transplantation
- Lymphoproliferative disorder following kidney transplant
- Lymphoproliferative disorder following liver transplant
- Lymphoproliferative disorder following lung transplant
- Lymphoproliferative disorder following transplantation
- Monomorphic posttransplant lymphoproliferative disorder
- Neoplasia following lung transplant
- Neoplasm following transplantation of bone marrow
- Neoplasm following transplantation of kidney
- Neoplasm following transplantation of liver
- Polymorphic lymphoproliferative disorder following transplant
- Reactive plasmacytic hyperplasia post-transplant lymphoproliferative disorder
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to D47.Z1: its own notes plus those printed at block D37-D48 and Chapter 2. A note printed at a category, block or chapter applies to every code under it.
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
- neoplasms of unspecified behavior (D49.-)
Code First
The underlying condition named in the note is sequenced before this code.
- complications of transplanted organs and tissue (T86.-)
Notes
General instructions on how these codes are used.
- Functional activity
- All neoplasms are classified in this chapter, whether they are functionally active or not. An additional code from Chapter 4 may be used, to identify functional activity associated with any neoplasm.
- Morphology [Histology]
- Chapter 2 classifies neoplasms primarily by site (topography), with broad groupings for behavior, malignant, in situ, benign, etc. The Table of Neoplasms should be used to identify the correct topography code. In a few cases, such as for malignant melanoma and certain neuroendocrine tumors, the morphology (histologic type) is included in the category and codes.
- Primary malignant neoplasms overlapping site boundaries
- A primary malignant neoplasm that overlaps two or more contiguous (next to each other) sites should be classified to the subcategory/code .8 ('overlapping lesion'), unless the combination is specifically indexed elsewhere. For multiple neoplasms of the same site that are not contiguous, such as tumors in different quadrants of the same breast, codes for each site should be assigned.
- Malignant neoplasm of ectopic tissue
- Malignant neoplasms of ectopic tissue are to be coded to the site mentioned, e.g., ectopic pancreatic malignant neoplasms are coded to pancreas, unspecified (C25.9).
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name D47.Z1, its category, or a range that includes it.
Use Additional Code 1
These codes say to use an additional code from the note, and D47.Z1 is one of the codes named.
- T86 Complications of transplanted organs and tissuepost-transplant lymphoproliferative disorders (PTLD) (D47.Z1)
Index to Diseases and InjuriesGuidance
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Post-Transplant Lymphoproliferative Disorder
post-transplant lymphoproliferative disorder (ptld) is a polyclonal (benign) or clonal (malignant) proliferation of lymphoid cells that develops as a consequence of immunosuppression in a recipient of a solid organ or bone marrow allograft. ptlds comprise a spectrum ranging from early, epstein-barr virus (ebv)-driven polyclonal lymphoid proliferations to ebv-positive or ebv- negative lymphomas of predominantly b-cell or less often t-cell type. (who, 2001)
Patient EducationClinical
Immune System and Disorders
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Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert D47.Z1 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About D47.Z1Overview
What is the ICD-10 code for post-transplant lymphoproliferative disorder (PTLD)?
The ICD-10-CM code for post-transplant lymphoproliferative disorder (PTLD) is D47.Z1 (sometimes written as D47Z1). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is D47.Z1 a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report post-transplant lymphoproliferative disorder (PTLD) on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does D47.Z1 group to?
On inpatient claims, post-transplant lymphoproliferative disorder (PTLD) maps to MS-DRG 920, 919, 921, with relative weights from 0.6719 to 1.7624 depending on complications. Higher weights mean higher Medicare reimbursement.
Is D47.Z1 a CC or MCC?
CMS lists D47.Z1 as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 52 closely related codes in its exclusion list.
Can D47.Z1 be a principal diagnosis?
No. The Medicare Code Editor rejects this code as a principal diagnosis because post-transplant lymphoproliferative disorder (PTLD) describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.
What HCC is D47.Z1?
D47.Z1 (post-transplant lymphoproliferative disorder (PTLD)) maps to CMS-HCC Category 21 (Lymphoma and Other Cancers), commonly written as HCC 21, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 48 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. It does not map to any RxHCC in the Part D prescription drug model.
Does D47.Z1 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, D47.Z1 adds a risk adjustment factor of about 0.671 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.493 to 0.739 depending on the payment segment). A more severe related category (HCC 17, HCC 18, HCC 19, and HCC 20) supersedes it when both are reported. See the full factor table on the HCC 21 category page.
