2027 ICD-10-CM Diagnosis Code T86.852Intestine transplant infection
ICD-10-CM Codes›S00–T88›T80-T88›T86
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Risk Adjusts — HCC 77
- Chronic Condition
T86.852 is a billable ICD-10-CM diagnosis code for intestine transplant infection. 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. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Complication of transplanted organs or tissue, initial encounter.
For Medicare Advantage risk adjustment, T86.852 maps to CMS-HCC Category 77 (Intestine Transplant Status/Complications) under the V28 model, adding a risk factor of about 1.172 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
T86.852 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.
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 2027, published by CMS and the National Center for Health Statistics.
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to T86.852: its own notes plus those printed at T86, block T80-T88, and Chapter 19. A note printed at a category, block or chapter applies to every code under it.
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
- any encounters with medical care for postprocedural conditions in which no complications are present, such as:
- artificial opening status (Z93.-)
- closure of external stoma (Z43.-)
- fitting and adjustment of external prosthetic device (Z44.-)
- burns and corrosions from local applications and irradiation (T20-T32)
- complications of surgical procedures during pregnancy, childbirth and the puerperium (O00-O9A)
- mechanical complication of respirator [ventilator] (J95.850)
- poisoning and toxic effects of drugs and chemicals (T36-T65 with fifth or sixth character 1-4 or 6)
- postprocedural fever (R50.82)
- specified complications classified elsewhere, such as:
- cerebrospinal fluid leak from spinal puncture (G97.0)
- colostomy malfunction (K94.0-)
- disorders of fluid and electrolyte imbalance (E86-E87)
- functional disturbances following cardiac surgery (I97.0-I97.1)
- 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.-)
- ostomy complications (J95.0-, K94.-, N99.5-)
- postgastric surgery syndromes (K91.1)
- postlaminectomy syndrome NEC (M96.1)
- postmastectomy lymphedema syndrome (I97.2)
- postsurgical blind-loop syndrome (K91.2)
- ventilator associated pneumonia (J95.851)
Use Additional Code
Add a second code, after this one, to fully describe the condition.
- code to specify infection
- code to identify any retained foreign body, if applicable (Z18.-)
Notes
General instructions on how these codes are used.
- Use secondary code(s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code
- The chapter uses the S-section for coding different types of injuries related to single body regions and the T-section to cover injuries to unspecified body regions as well as poisoning and certain other consequences of external causes.
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name T86.852, its category, or a range that includes it.
Excludes1 1
These codes carry an Excludes1 note naming T86.852: they are not reported together with it, unless the two conditions are unrelated.
Excludes2 6
These codes carry an Excludes2 note naming T86.852: its condition is not part of those codes, and both may be reported when the patient has both.
- D89 Other disorders involving the immune mechanism, not elsewhere classifiedtransplant failure and rejection (T86.-) names T86.-, which includes this code
- T81 Complications of procedures, not elsewhere classifiedcomplications of transplanted organs and tissue (T86.-) names T86.-, which includes this code
- T82 Complications of cardiac and vascular prosthetic devices, implants and graftsfailure and rejection of transplanted organs and tissue (T86.-) names T86.-, which includes this code
- T83 Complications of genitourinary prosthetic devices, implants and graftsfailure and rejection of transplanted organs and tissue (T86.-) names T86.-, which includes this code
- T84 Complications of internal orthopedic prosthetic devices, implants and graftsfailure and rejection of transplanted organs and tissues (T86.-) names T86.-, which includes this code
- T85 Complications of other internal prosthetic devices, implants and graftsfailure and rejection of transplanted organs and tissue (T86.-) names T86.-, which includes this code
Code First 4
These codes say to code first a condition named in the note, and T86.852 is one of the conditions named.
- C80.2 Malignant neoplasm associated with transplanted organcomplication of transplanted organ (T86.-) names T86.-, which includes this code
- D47.Z1 Post-transplant lymphoproliferative disorder (PTLD)complications of transplanted organs and tissue (T86.-) names T86.-, which includes this code
- D89.81 Graft-versus-host diseasecomplications of transplanted organs and tissue (T86.-) names T86.-, which includes this code
- D89.83 Cytokine release syndromecomplications of transplanted organs and tissue (T86.-) names T86.-, which includes this code
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Convert T86.852 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About T86.852Overview
What is the ICD-10 code for intestine transplant infection?
The ICD-10-CM code for intestine transplant infection is T86.852 (sometimes written as T86852). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is T86.852 (Complication of intestine transplant) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report intestine transplant infection on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does T86.852 group to?
When intestine transplant infection is the principal diagnosis on an inpatient stay, it groups 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 T86.852 a CC or MCC?
CMS lists T86.852 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.
Does T86.852 need an additional code?
When the condition applies, yes. The Use Additional Code note reads: code to specify infection. The additional code is reported after T86.852.
What HCC is T86.852?
T86.852 (intestine transplant infection) maps to CMS-HCC Category 77 (Intestine Transplant Status/Complications), commonly written as HCC 77, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 186 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. In the Part D prescription drug model it maps to RxHCC 396.
Does T86.852 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, T86.852 adds a risk adjustment factor of about 1.172 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 1.172 to 6.301 depending on the payment segment). HCC 77 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 77 category page.