D89.811 ICD-10-CM Code: Chronic graft-versus-host disease

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for D89.811 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 D89.811 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.

Coder workflow for D89.811

MedCoder structured workflow — derived from this code’s own official record

Before you code D89.811

1. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with D89.811. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

   See the official tabular notes

Choose the right path

1. Does the documentation support a condition named in D89.811’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.

   ReviewR77.1, D47.2, M35.9, D71

2. Is the underlying (etiologic) condition the Code First note names documented?
   Yes → Sequence the underlying condition first, then D89.811.
   No → Continue; do not add an underlying condition the record does not document.

   ReviewT86, T80.89

Consider D89.811. 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).

Acuity

Acute or chronic as documented; when both are documented and separate codes exist, both are reported with the acute code first (Guidelines I.B.8).

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 D89.811(4 notes)

  Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with D89.811: 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 D89.811(2 notes)

  Coding workflow: The conditions named in this note are not included in D89.811. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

  CompareT86, B20

  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 D89.811. Do not add an underlying condition the record does not document.

  ReviewT86, T80.89

  See the official tabular notes · Guidelines I.A.13

• Use Additional Code — after identifying D89.811(5 notes)

  Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with D89.811 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

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.

Indexed Clinical Terms (3)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

• Disease, diseased, graft-versus-host (GVH), chronic
• Disease, diseased, host-versus-graft, chronic
• Graft-versus-host disease, chronic

Official Coding Guidelines

No excerpt in the ICD-10-CM Official Guidelines names this code specifically. Its chapter carries only this chapter-wide note:

Don’t confuse D89.811 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of D89.811 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

• R77.1— Excludes1 conflict (Excludes1 — generally not reported together)

  Not coded here — the tabular list excludes this pair for the same encounter.

  Not reported together with this code, except where the two conditions are documented as unrelated.

  What moves you there: Documentation of hyperglobulinemia NOS moves the case to R77.1; the two are not reported together unless documented as unrelated.

  Full comparison: D89.811 vs R77.1 →

• D47.2— Excludes1 conflict (Excludes1 — generally not reported together)

  Not coded here — the tabular list excludes this pair for the same encounter.

  Not reported together with this code, except where the two conditions are documented as unrelated.

  What moves you there: Documentation of monoclonal gammopathy (of undetermined significance) moves the case to D47.2; the two are not reported together unless documented as unrelated.

  Full comparison: D89.811 vs D47.2 →

• M35.9— Excludes1 conflict (Excludes1 — generally not reported together)

  Not coded here — the tabular list excludes this pair for the same encounter.

  Not reported together with this code, except where the two conditions are documented as unrelated.

  What moves you there: Documentation of autoimmune disease (systemic) NOS moves the case to M35.9; the two are not reported together unless documented as unrelated.

  Full comparison: D89.811 vs M35.9 →

• D71— Excludes1 conflict (Excludes1 — generally not reported together)

  Not coded here — the tabular list excludes this pair for the same encounter.

  Not reported together with this code, except where the two conditions are documented as unrelated.

  What moves you there: Documentation of functional disorders of polymorphonuclear neutrophils moves the case to D71; the two are not reported together unless documented as unrelated.

  Full comparison: D89.811 vs D71 →

• D89.813— Specificity relationship (Review)

  Overlapping diagnoses in the same category.

  Overlapping codes in the same category — the documentation decides which is the more specific fit.

  What moves you there: A record that documents no more than “Graft-versus-host disease, unspecified” takes D89.813; specificity in the record moves it back here.

  Full comparison: D89.811 vs D89.813 →

• T86— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of transplant failure and rejection adds T86; it is not part of this code and both may be reported when both are documented.

  Full comparison: D89.811 vs T86 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Decision Points

The directives on this code's own record, as a pre-claim checklist.

1. Sequencing: 3 Code First instructions — the underlying condition is sequenced before this code when present. See the Code First notes
2. 5 Use Additional Code instructions — report the named additional code(s) when the documentation supports them. See the Use Additional Code notes
3. 4 Excludes1 entries — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes
4. 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

• Principal-diagnosis restriction. The Medicare Code Editor lists this code as unacceptable as a principal diagnosis: it describes a circumstance influencing health status rather than a current illness or injury being treated. It is valid as a secondary diagnosis.
• CC as a secondary diagnosis (FY2026). Can raise the stay's MS-DRG severity tier.

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 D89.811 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] (via D89.81.-), T80.89 — Other complications following infusion, transfusion and therapeutic injection (via D89.81.-), T86 — Complications of transplanted organs and tissue (via D89.81.-).

These codes instruct coders to additionally report this code when it applies.

Referenced by 1 Code Also instruction: J44.81 — Bronchiolitis obliterans and bronchiolitis obliterans syndrome.

These codes suggest coding this condition alongside when both are present.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 45 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 3 MS-DRGs: DRG 808 (MDC 16), DRG 809 (MDC 16), DRG 810 (MDC 16).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):BLD008 — Immunity disorders (default); INJ036 — Complication of transplanted organs or tissue, initial encounter.

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical process (MS-DRG)

Acts as CC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.

D78.81 — Other intraoperative complications of the spleen, D78.89 — Other postprocedural complications of the spleen, E89.810 — Postprocedural hemorrhage of an endocrine system organ or structure following an endocrine system procedure, E89.811 — Postprocedural hemorrhage of an endocrine system organ or structure following other procedure, E89.820 — Postprocedural hematoma of an endocrine system organ or structure following an endocrine system procedure, E89.821 — Postprocedural hematoma of an endocrine system organ or structure following other procedure, E89.822 — Postprocedural seroma of an endocrine system organ or structure following an endocrine system procedure, E89.823 — Postprocedural seroma of an endocrine system organ or structure following other procedure, E89.89 — Other postprocedural endocrine and metabolic complications and disorders, H59.011 — Keratopathy (bullous aphakic) following cataract surgery, right eye, H59.012 — Keratopathy (bullous aphakic) following cataract surgery, left eye, H59.013 — Keratopathy (bullous aphakic) following cataract surgery, bilateral, H59.019 — Keratopathy (bullous aphakic) following cataract surgery, unspecified eye, H59.031 — Cystoid macular edema following cataract surgery, right eye, H59.032 — Cystoid macular edema following cataract surgery, left eye, H59.033 — Cystoid macular edema following cataract surgery, bilateral, H59.039 — Cystoid macular edema following cataract surgery, unspecified eye, H59.091 — Other disorders of the right eye following cataract surgery, H59.092 — Other disorders of the left eye following cataract surgery, H59.093 — Other disorders of the eye following cataract surgery, bilateral, +25 more

Principal diagnosis restriction (Medicare Code Editor)

Not acceptable as a principal diagnosis on an inpatient claim.

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Stem Cell, Including Bone Marrow, Transplant Status/Complications) for risk-adjusted payment.

D89.810 — Acute graft-versus-host disease, D89.812 — Acute on chronic graft-versus-host disease, D89.813 — Graft-versus-host disease, unspecified, M31.11 — Hematopoietic stem cell transplantation-associated thrombotic microangiopathy [HSCT-TMA], T86.00 — Unspecified complication of bone marrow transplant, T86.01 — Bone marrow transplant rejection, T86.02 — Bone marrow transplant failure, T86.03 — Bone marrow transplant infection, T86.09 — Other complications of bone marrow transplant, T86.5 — Complications of stem cell transplant, Z48.290 — Encounter for aftercare following bone marrow transplant, Z94.81 — Bone marrow transplant status, Z94.84 — Stem cells transplant status

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical categories (Immunity disorders, Complication of transplanted organs or tissue, initial encounter).

D89.1 — Cryoglobulinemia, D89.2 — Hypergammaglobulinemia, unspecified, D89.3 — Immune reconstitution syndrome, D89.40 — Mast cell activation, unspecified, D89.41 — Monoclonal mast cell activation syndrome, 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, D89.810 — Acute 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], D89.831 — Cytokine release syndrome, grade 1, D89.832 — Cytokine release syndrome, grade 2, D89.833 — Cytokine release syndrome, grade 3, D89.834 — Cytokine release syndrome, grade 4, D89.835 — Cytokine release syndrome, grade 5, D89.839 — Cytokine release syndrome, grade unspecified, D89.84 — IgG4-related disease, +157 more

Contextual Map

Every relationship of D89.811 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 D89.811 with these 5 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
• D80-D89 — Certain disorders involving the immune mechanism[Hierarchy]— CMS ICD-10-CM tabular structure · 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](via D89.81.-): “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](via D89.81.-): “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](via D89.81.-): “graft-versus-host disease (D89.81-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Code Also instructions

• J44.81 — Bronchiolitis obliterans and bronchiolitis obliterans syndrome[Code Also]: “chronic graft-versus-host disease (D89.811)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Clinical classification (CCSR)

• BLD008 — Immunity disorders[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)
• INJ036 — Complication of transplanted organs or tissue, initial encounter[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)

Risk adjustment (CMS-HCC)

• HCC 454 — Stem Cell, Including Bone Marrow, Transplant Status/Complications [CMS-HCC]— CMS-HCC V28 · 2026

MS-DRG Grouper

• CC — Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (CC).”— CMS MS-DRG Definitions Manual (Appendix C) · FY2026
• DRG 808 — MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC[MS-DRG]: “MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC (MDC 16)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 809 — MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC[MS-DRG]: “MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC (MDC 16)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 810 — MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC[MS-DRG]: “MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC (MDC 16)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026

MDC crossing

• MDC 16 — Diseases and Disorders of Blood, Blood Forming Organs and Immunologic Disorders[MDC crossing]: “Diseases and Disorders of Blood, Blood Forming Organs and Immunologic Disorders — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 1,614 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

• Disease, diseased, graft-versus-host (GVH), chronic[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Disease, diseased, host-versus-graft, chronic[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Graft-versus-host disease, chronic[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · 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

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

Coding guidelines Official source data

ICD-10-CM Official Guidelines for Coding and Reporting (FY2026), quoted by section 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

Inpatient payment groups Official source data

CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page

Risk adjustment Official source data

2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release 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

Nearest Codes in This Family

Official ICD-10-CM classifications closest to D89.811 in its code family, with their registry titles.

• D89.44 — Hereditary alpha tryptasemia
• D89.49 — Other mast cell activation disorder
• D89.8 — Other specified disorders involving the immune mechanism, not elsewhere classified
• D89.81 — Graft-versus-host disease
• D89.810 — Acute 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]
• D89.83 — Cytokine release syndrome
• D89.831 — Cytokine release syndrome, grade 1

View all codes in the D89 family