2026 ICD-10-CM Diagnosis Code T86.20Unspecified complication of heart transplant

ICD-10-CM Codes›S00–T88›T80-T88›T86

ICD-10-CM T86.20
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

T86.20 is a billable ICD-10-CM diagnosis code for unspecified complication of heart transplant. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 314 through 316. Coders also document this condition as disorder of transplanted heart. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Complication of transplanted organs or tissue, initial encounter.

Code Identity

ICD-10-CM Code
T86.20
Billable Status
Yes — Valid for Submission
Code Describes
Unspecified complication of heart transplant
Short Description
Unspecified complication of heart transplant
Same as the full description in the CMS dataset.
Parent Code
T86.2
Complications of heart transplant

Code Classification

ChapterS00–T88Injury, poisoning and certain other consequences of external causes
SectionT80-T88Complications of surgical and medical care, not elsewhere classified
CategoryT86Complications of transplanted organs and tissue
This CodeT86.20Unspecified complication of heart transplant

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Disorder of transplanted heart
  • Disorder related to cardiac transplantation

Coding GuidelinesGuidance

The appropriate 7th character is to be added to each code from block Complications of transplanted organs and tissue (T86). Use the following options for the applicable episode of care:

  • A - initial encounter
  • D - subsequent encounter
  • S - sequela

Source: ICD-10-CM Official Guidelines for Coding and Reporting, FY 2026, published by CMS and the National Center for Health Statistics.

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Complication(s) (from) (of)
      • transplant
        • heart

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR INJ036
Complication of transplanted organs or tissue, initial encounter
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Heart Transplantation

A heart transplant removes a damaged or diseased heart and replaces it with a healthy one. The healthy heart comes from a donor who has died. It is the last resort for people with heart failure when all other treatments have failed.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert T86.20 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
996.83 Compl heart transplant
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About T86.20Overview

Is T86.20 (Complications of heart transplant) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report unspecified complication of heart transplant on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does T86.20 group to?

When unspecified complication of heart transplant is the principal diagnosis on an inpatient stay, it groups to MS-DRG 314, 315, 316, with relative weights from 0.6821 to 2.0852 depending on complications. Higher weights mean higher Medicare reimbursement.

What is the ICD-9 equivalent of T86.20?

Under the General Equivalence Mappings, unspecified complication of heart transplant converts to ICD-9-CM 996.83 (compl heart transplant). The mapping is approximate, so confirm the match fits the documentation.

Footnotes

[1] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:

  • The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
  • The condition places limitations on self-care, independent living, and social interactions.