T85.72 vs T86
T85.72 (Infection and inflammatory reaction due to insulin pump) compared with T86 (Complications of transplanted organs and tissue), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).
Can these codes be reported together?
Yes, when both are documented. T85.72 carries an Excludes2 note covering T86: “failure and rejection of transplanted organs and tissue (T86.-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| T85.72Infection and inflammatory reaction due to insulin pump | T86Complications of transplanted organs and tissue | |
|---|---|---|
| Billing status | Non-billable header | Non-billable header |
| Classification | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) |
| Definition | Infection and inflammatory reaction due to insulin pump is a non-billable ICD-10-CM category code (T85.72). | Complications of transplanted organs and tissue is a non-billable ICD-10-CM category code (T86). |
| 7th character | The appropriate 7th character is to be added to each code from category T85 | — |
| Use additional code | code to identify infection 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 other transplant complications, such as: graft-versus-host disease (D89.81-) malignancy associated with organ transplant (C80.2) |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources