ICD-10 Coding for Renal Transplant(T86.11, T86.13)
Complete ICD-10-CM coding and documentation guide for Renal Transplant. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Renal Transplant
T86.1-Primary Range
Complications of transplanted kidney
Covers various complications related to kidney transplants, including rejection, failure, and infections.
Kidney transplant status
Indicates the status of a kidney transplant, often used in conjunction with CKD codes.
End-stage renal disease (ESRD)
Used to describe ESRD, often in patients who have undergone a renal transplant.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| T86.11 | Acute rejection of kidney transplant | Use when there is biopsy-confirmed acute rejection of the transplanted kidney. |
|
| T86.13 | Kidney transplant infection | Use when there is a documented infection in the transplanted kidney. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for kidney transplant infection
Essential facts and insights about Renal Transplant
Primary ICD-10-CM Codes for renal transplant
Decision Criteria
clinical Criteria
- Biopsy-confirmed acute rejection with elevated DSA.
Applicable To
- Acute cellular rejection
- Antibody-mediated rejection
Excludes
- Chronic rejection of kidney transplant (T86.12)
Clinical Validation Requirements
- Biopsy results with Banff classification
- Elevated donor-specific antibodies (DSA)
Code-Specific Risks
- Misclassification if biopsy results are not available.
Coding Notes
- Ensure biopsy results are documented to support the use of this code.
T86.13 - Kidney transplant infection
Use when there is a documented infection in the transplanted kidney.
Applicable To
- Infection of transplanted kidney
Excludes
- Rejection of kidney transplant (T86.11)
Clinical Validation Requirements
- Positive urine culture
- Clinical signs of infection
Coding Notes
Ensure proper sequencing with sepsis codes.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Renal Transplant to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code T86.11.
Impact
Clinical: Inaccurate representation of patient condition., Regulatory: Non-compliance with coding standards., Financial: Potential for claim denials.
Mitigation Strategy
Always pair Z94.0 with the appropriate CKD stage code.
Impact
Reimbursement: Incorrect sequencing can lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Always sequence sepsis codes before transplant infection codes.
Impact
Failure to link CKD stage with transplant status.
Mitigation Strategy
Implement regular audits of coding practices.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Renal Transplant, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Renal Transplant
Use these documentation templates to ensure complete and accurate documentation for Renal Transplant. These templates include all required elements for proper coding and billing.
Post-Transplant Infection
Specialty: NephrologyRequired Elements
- Patient demographics
- Transplant history
- Infection details
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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