ICD-10 Coding for Kidney Transplant(T86.100, Z94.0)
Complete ICD-10-CM coding and documentation guide for Kidney Transplant. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Kidney Transplant
T86.1-T86.19Primary Range
Complications of transplanted organs and tissues, kidney
This range covers complications specific to kidney transplants, including rejection and failure.
Kidney transplant status
Used to indicate the status of a kidney transplant when no complications are present.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| T86.100 | Unspecified complication of kidney transplant | Use when biopsy confirms rejection and there is evidence of graft dysfunction. |
|
| Z94.0 | Kidney transplant status | Use when the patient has a kidney transplant without complications. |
|
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 complications
Essential facts and insights about Kidney Transplant
Primary ICD-10-CM Codes for transplant kidney
Decision Criteria
clinical Criteria
- Biopsy shows Banff criteria for rejection.
Applicable To
- Acute rejection of kidney transplant
Excludes
- Chronic kidney disease (N18.-)
Clinical Validation Requirements
- Biopsy-confirmed rejection (Banff criteria)
- Elevated creatinine levels
Code-Specific Risks
- Incorrect use without biopsy confirmation
Coding Notes
- Ensure biopsy results are documented.
Z94.0 - Kidney transplant status
Use when the patient has a kidney transplant without complications.
Applicable To
- History of kidney transplant
Excludes
- Complications of kidney transplant (T86.1-)
Clinical Validation Requirements
- Stable transplant without complications
Coding Notes
Do not use if there is a documented complication.
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.
Kidney transplant failure
T86.101Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Kidney Transplant to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code T86.100.
Impact
Clinical: Misrepresentation of patient's condition., Regulatory: Potential audit issues., Financial: Incorrect reimbursement.
Mitigation Strategy
Ensure documentation links CKD to transplant status.
Impact
Reimbursement: Incorrect coding can lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use T86.1- series codes for complications.
Impact
Incorrect coding of transplant complications.
Mitigation Strategy
Ensure biopsy and lab results are documented.
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 Kidney Transplant, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Kidney Transplant
Use these documentation templates to ensure complete and accurate documentation for Kidney Transplant. These templates include all required elements for proper coding and billing.
Post-Transplant Follow-Up
Specialty: NephrologyRequired Elements
- Vital signs
- Lab results
- Graft examination
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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