ICD-10-CM Code Z94.81

Bone marrow transplant status

Version 2020 Billable Code Unacceptable Principal Diagnosis POA Exempt

Valid for Submission

Z94.81 is a billable code used to specify a medical diagnosis of bone marrow transplant status. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Z94.81 might also be used to specify conditions or terms like bone marrow transplant present or growth hormone deficiency after bone marrow transplant or history of allotransplantation of bone marrow or history of autologous bone marrow transplant or history of bone marrow transplant. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

The code Z94.81 describes a circumstance which influences the patient's health status but not a current illness or injury. The code is unacceptable as a principal diagnosis.

ICD-10:Z94.81
Short Description:Bone marrow transplant status
Long Description:Bone marrow transplant status

Index to Diseases and Injuries

The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code Z94.81 are found in the index:


Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:

  • Unacceptable principal diagnosis - There are selected codes that describe a circumstance which influences an individual’s health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.

Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • Bone marrow transplant present
  • Growth hormone deficiency after bone marrow transplant
  • History of allotransplantation of bone marrow
  • History of autologous bone marrow transplant
  • History of bone marrow transplant

Diagnostic Related Groups

The ICD-10 code Z94.81 is grouped in the following groups for version MS-DRG V37.0 What are Diagnostic Related Groups?
The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC).
applicable from 10/01/2020 through 09/30/2020.

  • 814 - RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC
  • 815 - RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC
  • 816 - RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC

Present on Admission (POA)

Z94.81 is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here .

CMS POA Indicator Options and Definitions
POA Indicator CodePOA Reason for CodeCMS will pay the CC/MCC DRG?
YDiagnosis was present at time of inpatient admission.YES
NDiagnosis was not present at time of inpatient admission.NO
UDocumentation insufficient to determine if the condition was present at the time of inpatient admission.NO
WClinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.YES
1Unreported/Not used - Exempt from POA reporting. NO

Convert Z94.81 to ICD-9

  • V42.81 - Trnspl status-bne marrow (Approximate Flag)

Code Classification

  • Factors influencing health status and contact with health services (Z00–Z99)
    • Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99)
      • Transplanted organ and tissue status (Z94)

Code History

  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
    (First year ICD-10-CM implemented into the HIPAA code set)
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020

Information for Patients


Bone Marrow Transplantation

Bone marrow is the spongy tissue inside some of your bones, such as your hip and thigh bones. It contains immature cells, called stem cells. The stem cells can develop into red blood cells, which carry oxygen throughout the body, white blood cells, which fight infections, and platelets, which help the blood to clot.

A bone marrow transplant is a procedure that replaces a person's faulty bone marrow stem cells. Doctors use these transplants to treat people with certain diseases, such as

  • Leukemia
  • Severe blood diseases such as thalassemias, aplastic anemia, and sickle cell anemia
  • Multiple myeloma
  • Certain immune deficiency diseases

Before you have a transplant, you need to get high doses of chemotherapy and possibly radiation. This destroys the faulty stem cells in your bone marrow. It also suppresses your body's immune system so that it won't attack the new stem cells after the transplant.

In some cases, you can donate your own bone marrow stem cells in advance. The cells are saved and then used later on. Or you can get cells from a donor. The donor might be a family member or unrelated person.

Bone marrow transplantation has serious risks. Some complications can be life-threatening. But for some people, it is the best hope for a cure or a longer life.

NIH: National Heart, Lung, and Blood Institute


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