Billable ICD-10-CM code, FY2026. Acts as a Complication or Comorbidity (CC) as a secondary diagnosis. Exempt from present-on-admission (POA) reporting.
Applies from Z94 Transplanted organ and tissue status
Includes
organ or tissue replaced by heterogenous or homogenous transplant
Excludes1 (never code together)
complications of transplanted organ or tissue - see Alphabetical Index
Excludes2 (not included here)
presence of vascular grafts (Z95.-)
Risk adjustment (HCC)
CMS-HCC V28: HCC 454 — Stem Cell, Including Bone Marrow, Transplant Status/Complications
CMS-HCC V22: HCC 186 — Major Organ Transplant or Replacement Status
RxHCC V08: HCC 395 — Stem Cell, Including Bone Marrow, Transplant Status/Complications
ESRD V24: HCC 186
MS-DRG index
Defines the logic of DRG(s) 814-816 in MDC 16.
Approximate ICD-9-CM (GEMs)
V42.81 Bone marrow replaced by transplant (approximate)
Medicare Code Edits (MCE v43.1 (April 2026))
Unacceptable principal diagnosis: These codes describe a circumstance which influences care but is not a current illness or injury, or capture only an underlying condition, and are unacceptable as principal diagnosis.
Code annotations containing back-references to Z94.81
Back-references to Z94
Type 1 Excludes: Z18 Retained foreign body fragments ("organ or tissue replaced by transplant (Z94.-)")
Type 2 Excludes: Z78 Other specified health status ("postprocedural status (Z93-Z99)")
Type 2 Excludes: Z87.7 Personal history of (corrected) congenital malformations ("transplanted organ and tissue status (Z94.-)")