ICDcodes.org
FY2027

T86.8419 — Corneal transplant failure, unspecified eye

BillableUnspecifiedCC

Is T86.8419 billable?

Yes, but T86.8419 will trip a Medicare edit. T86.8419 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists T86.8419 under Medicare Code Editor edit 20, “Unspecified code” — meaning a code specifying laterality (right, left or bilateral) exists in the same family. On an inpatient claim this triggers the edit, because CMS holds that there are very limited circumstances in which laterality cannot be documented.

T86.8419 at a glance

CodeT86.8419
DescriptionCorneal transplant failure, unspecified eye
BillableYes
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027

What Medicare edits apply to T86.8419?

The Medicare Code Editor screens inpatient claims before they are grouped. These edits name T86.8419 directly.

Unspecified — a laterality-specific code exists — MCE edit 20

A code specifying laterality (right, left or bilateral) exists in the same family. CMS holds that there are very limited circumstances in which laterality cannot be documented.

Which MS-DRGs does T86.8419 group to?

T86.8419 sits in MDC 02 and helps define the logic of 2 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.

  • 124Other Disorders of the Eye with MCC or Thrombolytic Agentmedical
  • 125Other Disorders of the Eye without MCCmedical

As a secondary diagnosis, T86.8419 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.

How is T86.8419 listed in the Alphabetic Index?

The Alphabetic Index lists these routes under T86.841, the nearest indexed parent of T86.8419. Use them to find the family, then select the specific code.

  • Failure, failed › transplant › cornea
  • Complication › graft › cornea › failure (s) (from) (of)
  • Complication › transplant › cornea › failure (s) (from) (of)

Use additional code — inherited from Chapter 19

Report an additional code alongside T86.8419 to fully describe the condition. T86.8419 is sequenced first.

  • code to identify any retained foreign body, if applicable (Z18.-)

Use additional code — inherited from T80-T88

Report an additional code alongside T86.8419 to fully describe the condition. T86.8419 is sequenced first.

  • code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)
  • code(s) to identify the specified condition resulting from the complication
  • code to identify devices involved and details of circumstances (Y62-Y82)

Use additional code — inherited from T86

Report an additional code alongside T86.8419 to fully describe the condition. T86.8419 is sequenced first.

  • code to identify other transplant complications, such as:
  • graft-versus-host disease (D89.81-)
  • malignancy associated with organ transplant (C80.2)
  • post-transplant lymphoproliferative disorders (PTLD) (D47.Z1)

Excludes2 — not included here — inherited from Chapter 19

The conditions below are not part of T86.8419, but a patient may have both at the same time. When documentation supports it, T86.8419 and the excluded code may both be reported.

  • birth trauma (P10-P15)
  • obstetric trauma (O70-O71)

Excludes2 — not included here — inherited from T80-T88

The conditions below are not part of T86.8419, but a patient may have both at the same time. When documentation supports it, T86.8419 and the excluded code may both 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)

Excludes2 — not included here — inherited from T86.84

The conditions below are not part of T86.8419, but a patient may have both at the same time. When documentation supports it, T86.8419 and the excluded code may both be reported.

  • mechanical complications of corneal graft (T85.3-)

How long has T86.8419 existed?

T86.8419 first appears in FY2021 (FY2020 is not available, so it may have appeared then).

Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.

What other codes are in the T86.841 family? (3)