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2025 ICD-10-CM code T86.290

Cardiac allograft vasculopathy is a complication of heart transplant.

Always use appropriate secondary codes from Chapter 20 (External causes of morbidity) to identify the cause of the cardiac allograft vasculopathy.If a retained foreign body is present, use code(s) from the Z18.- category.

The medical necessity for coding T86.290 rests on the presence of clinical evidence indicating the development of vascular disease in the transplanted heart.This evidence must be documented clearly, demonstrating the impact on cardiac function and the need for intervention to preserve the patient's health.

The clinical responsibility for managing cardiac allograft vasculopathy rests primarily with cardiologists and cardiac surgeons.This involves ongoing monitoring, diagnostic testing, and management of symptoms, which may include medication, interventions such as angioplasty or stenting, or, in severe cases, re-transplantation.

IMPORTANT:Consider additional codes to specify other transplant complications such as graft-versus-host disease (D89.81-), malignancy associated with organ transplant (C80.2), or post-transplant lymphoproliferative disorders (PTLD) (D47.Z1).

In simple words: Cardiac allograft vasculopathy is a problem that can happen after a heart transplant. It means the blood vessels in the new heart are getting sick, which can affect blood flow and cause other issues.

T86.290, Cardiac allograft vasculopathy, is an ICD-10-CM code that represents a specific complication arising after a heart transplant.It refers to the development of vascular disease within the transplanted heart, affecting the arteries and blood vessels. This condition can manifest in various ways, impacting blood flow to the transplanted organ and potentially leading to further complications.Appropriate secondary codes should be used to indicate the cause of the injury,as well as any retained foreign body (Z18.-) if applicable.Excludes1: atherosclerosis of coronary arteries (I25.75-, I25.76-, I25.81-), complication of artificial heart device (T82.5-), and heart-lung transplant (T86.3-).

Example 1: A 60-year-old male patient, 2 years post-heart transplant, presents with angina and shortness of breath. Cardiac catheterization reveals significant stenosis in the coronary arteries of the transplanted heart, consistent with cardiac allograft vasculopathy.The patient is started on medication to manage the condition., A 55-year-old female patient experiences sudden chest pain and decreased exercise tolerance 18 months post-transplant. Coronary angiography confirms significant allograft vasculopathy, and percutaneous coronary intervention (PCI) is performed to improve blood flow to the affected areas of the transplanted heart., A 70-year-old male patient, 5 years post-heart transplant, develops progressive heart failure symptoms due to severe allograft vasculopathy.Despite optimal medical management, the patient's condition deteriorates, and a heart retransplant is considered.

Detailed documentation is required to support the diagnosis of cardiac allograft vasculopathy. This includes the patient's history of heart transplantation,symptoms (e.g., angina, shortness of breath, fatigue), findings from physical examination, results of relevant investigations (e.g., echocardiography, cardiac catheterization, coronary angiography), and the course of treatment provided.

** The severity of cardiac allograft vasculopathy can range from mild to severe, significantly impacting patient prognosis.Careful clinical judgment is essential in accurately coding this condition.Additional codes may be required to fully capture the patient's condition.

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