D89.81 ICD-10-CM Code: Graft-versus-host disease
Billing Status: NO. This is a clinician non-billable / parent hierarchy grouping in the ICD-10-CM system.
Coding at a Glance
Coding instructions
Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for D89.81 in the official ICD-10-CM tabular list, quoted as published.
Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025
Notes without a marker are published on D89.81 itself; “inherited from” names the category or block whose note applies here.
This page already reflects the FY2027 tabular note taking effect October 1, 2026.
Includes
Conditions the official ICD-10-CM tabular list includes under this code.
- defects in the complement system
- immunodeficiency disorders, except human immunodeficiency virus [HIV] disease
- sarcoidosis
Source: inherited from D80-D89
Excludes1 — Not Coded Here
Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
- hyperglobulinemia NOS (R77.1) inherited from D89Compare D89.81 vs R77.1 →
- monoclonal gammopathy (of undetermined significance) (D47.2) inherited from D89Compare D89.81 vs D47.2 →
- autoimmune disease (systemic) NOS (M35.9) inherited from D80-D89Compare D89.81 vs M35.9 →
- functional disorders of polymorphonuclear neutrophils (D71-) inherited from D80-D89Compare D89.81 vs D71 →
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- transplant failure and rejection (T86.-) inherited from D89Compare D89.81 vs T86 →
- human immunodeficiency virus [HIV] disease (B20) inherited from D80-D89Compare D89.81 vs B20 →
Code First
Underlying conditions that must be sequenced before this code.
Coder workflow for D89.81
MedCoder structured workflow — derived from this code’s own official record
Before you code D89.81
- D89.81 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).
ReviewD89.810, D89.811, D89.812, D89.813
See the relationships section · Guide: How to choose an ICD-10-CM code →
- Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with D89.81. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).
Choose the right path
- Does the documentation support one of the more specific codes beneath D89.81?
Yes → Select that code and continue the checks below on its own page.
No → D89.81 cannot be reported as written; query for the specificity its subcategory needs. - Does the documentation support a condition named in D89.81’s Excludes1 note?
Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
No → Continue. - Is the underlying (etiologic) condition the Code First note names documented?
Yes → Sequence the underlying condition first, then D89.81.
No → Continue; do not add an underlying condition the record does not document.
Consider D89.81. Then work the Use Additional Code note, and confirm the code is valid for the date of service in the Verify section.
Documentation check
- The provider’s diagnostic statement
- Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
- The underlying (etiologic) condition
- Named in the Code First note; sequenced before this code when documented (Guidelines I.A.13).
- The conditions the Use Additional Code note names
- Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.
Official instructions as workflow
Excludes1 — check before selecting D89.81(4 notes)
Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with D89.81: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.
CompareR77.1, D47.2, M35.9, D71
See the official tabular notes · Guidelines I.A.12.a
Excludes2 — not part of D89.81(2 notes)
Coding workflow: The conditions named in this note are not included in D89.81. When the record documents both, both may be reported; the note is a boundary, not a prohibition.
See the official tabular notes · Guidelines I.A.12.b
Code First — sequencing check(3 notes)
Coding workflow: Check whether the underlying or etiologic condition the note names is documented. When it is, sequence it before D89.81. Do not add an underlying condition the record does not document.
See the official tabular notes · Guidelines I.A.13
Use Additional Code — after identifying D89.81(5 notes)
Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with D89.81 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.
ReviewL30.8, R19.7, R17, L65.9
See the official tabular notes · Guidelines I.A.13
Coding decision scenarios
Pattern scenarios for this code’s structure — decision rules, not clinical cases
Documentation: Both the condition D89.81 describes and a condition named in its Excludes1 note are documented for the same encounter.
Coding question: Can both codes be reported?
Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.
Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).
Documentation: The underlying condition the Code First note names is documented alongside this condition.
Coding question: How are the two sequenced?
Path: Review the Code First note.
Reason: The underlying condition is sequenced first and the manifestation follows (Guidelines I.A.13).
Documentation: A condition the Use Additional Code note names is documented.
Coding question: Is a second code reported with D89.81?
Path: Review the Use Additional Code note and the code it names.
Reason: The additional code is reported when the record documents the condition; a conditional instruction applies only when its condition is met (Guidelines I.A.13).
Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.
Code Overview
MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.
Decision Points
The directives on this code's own record, as a pre-claim checklist.
- Sequencing: 3 Code First instructions — the underlying condition is sequenced before this code when present. See the Code First notes
- 5 Use Additional Code instructions — report the named additional code(s) when the documentation supports them. See the Use Additional Code notes
- 4 Excludes1 entries — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes
- 2 Excludes2 entries — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 notes
Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.
Verify Before Coding
From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.
Relationships & Classification
MedCoder structured relationships — computed from published CMS and AHRQ datasets
Other codes that name D89.81 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.
Referenced by 1 Excludes1 note: D72 — Other disorders of white blood cells (via D89.-).
These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.
Referenced by 3 Use Additional Code instructions across 2 chapters: M31.11 — Hematopoietic stem cell transplantation-associated thrombotic microangiopathy [HSCT-TMA], T80.89 — Other complications following infusion, transfusion and therapeutic injection, T86 — Complications of transplanted organs and tissue.
These codes instruct coders to additionally report this code when it applies.
Contextual Map
Every relationship of D89.81 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.
Run D89.81 with these 8 related codes in Claim Check
Hierarchy
- D50-D89 — Chapter 3: Diseases of the Blood and Blood-forming Organs and Certain Disorders Involving the Immune Mechanism (D50-D89) (D50-D89)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Code First
- T80.89 — Other complications following infusion, transfusion and therapeutic injection[Code First]: “complications of blood transfusion (T80.89)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- T86 — Complications of transplanted organs and tissue[Code First]: “complications of transplanted organs and tissue (T86.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Use Additional Code
- L30.8 — Other specified dermatitis[Use Additional Code]: “desquamative dermatitis (L30.8)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- L65.9 — Nonscarring hair loss, unspecified[Use Additional Code]: “hair loss (L65.9)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- R17 — Unspecified jaundice[Use Additional Code]: “elevated bilirubin (R17)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- R19.7 — Diarrhea, unspecified[Use Additional Code]: “diarrhea (R19.7)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Referenced by Excludes1 notes
- D72 — Other disorders of white blood cells[Excludes1](via D89.-): “immunity disorders (D80-D89)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Referenced by Use Additional Code instructions
- M31.11 — Hematopoietic stem cell transplantation-associated thrombotic microangiopathy [HSCT-TMA][Use Additional Code]: “graft versus host disease (D89.81-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- T80.89 — Other complications following infusion, transfusion and therapeutic injection[Use Additional Code]: “code to identify graft-versus-host reaction, if applicable, (D89.81-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- T86 — Complications of transplanted organs and tissue[Use Additional Code]: “graft-versus-host disease (D89.81-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Nearest codes (28)
- D89 — Other disorders involving the immune mechanism, not elsewhere classified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- D89.0 — Polyclonal hypergammaglobulinemia[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- D89.1 — Cryoglobulinemia[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- D89.2 — Hypergammaglobulinemia, unspecified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- D89.3 — Immune reconstitution syndrome[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- D89.4 — Mast cell activation syndrome and related disorders[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- D89.40 — Mast cell activation, unspecified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- D89.41 — Monoclonal mast cell activation syndrome[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- and 20 more
Change history (3)
- FY2027 — Excludes2 note will be added[Change history]— CMS release files (code change ledger) · icd10cm-fy2027
- and 2 more
Common coding questions
Can D89.81 be billed directly?
No. D89.81 (Graft-versus-host disease) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.
Sources for this page
Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.
- Code, title, tabular notes and index terms Official source data
- CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
- Claim edits Official source data
- CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
- Change history and date-of-service validity Official source data
- CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
- Comparisons, relationships and the contextual map MedCoder structured relationship
- Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
- Summary and FAQ answers MedCoder explanation
- Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.
Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates
Cite this page
Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.
MedCoder.ai. "D89.81 — Graft-versus-host disease." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/d89.81-graft-versus-host-disease
Change history
- Upcoming · effective FY2027 — October 1, 2026Excludes2 note will be addedhuman immunodeficiency virus [HIV] disease (B20)FY2027 changes
- Upcoming · effective FY2027 — October 1, 2026Excludes1 note will be removedhuman immunodeficiency virus [HIV] disease (B20)FY2027 changes
- FY2016 — October 1, 2015In the code set at ICD-10-CM adoptionGraft-versus-host disease
Nearest Codes in This Family
Official ICD-10-CM classifications closest to D89.81 in its code family, with their registry titles.
- D89.42 — Idiopathic mast cell activation syndrome
- D89.43 — Secondary mast cell activation
- D89.44 — Hereditary alpha tryptasemia
- D89.49 — Other mast cell activation disorder
- D89.8 — Other specified disorders involving the immune mechanism, not elsewhere classified
- D89.810 — Acute graft-versus-host disease
- D89.811 — Chronic graft-versus-host disease
- D89.812 — Acute on chronic graft-versus-host disease
- D89.813 — Graft-versus-host disease, unspecified
- D89.82 — Autoimmune lymphoproliferative syndrome [ALPS]