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M31.11 ICD-10-CM Code: Hematopoietic stem cell transplantation-associated thrombotic microangiopathy [HSCT-TMA]

Compare with another codeCheck this code on a claim

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
5 inclusion terms · 1 Excludes1 · 13 use-additional codes · 3 code-first instructions
Risk adjustment
CMS-HCC V28: 1 category · CMS-HCC V22 category 186 · RxHCC V08 category 395

Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too; the Instructions section marks which is which.

Code firstSequence the underlying condition before this code
  • if applicable:
  • complications of bone marrow transplant (T86.0-)
  • complications of stem cell transplant (T86.5)
Use additional codeReport with this code when documented
  • code to identify specific organ dysfunction, such as:
  • acute kidney failure (N17.-)
  • acute respiratory distress syndrome (J80)
  • capillary leak syndrome (I78.8)

+9 more in Instructions

Excludes1Never report with this code
  • autoimmune disease, single organ or single cell-type -code to relevant condition category
IncludesWhat this code covers
  • autoimmune disease NOS
  • collagen (vascular) disease NOS
  • systemic autoimmune disease
  • systemic collagen (vascular) disease

+1 more in Instructions

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 545 — CONNECTIVE TISSUE DISORDERS WITH MCC (MDC 08)
  • MS-DRG 546 — CONNECTIVE TISSUE DISORDERS WITH CC (MDC 08)
  • MS-DRG 547 — CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC (MDC 08)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 454 — Stem Cell, Including Bone Marrow, Transplant Status/Complications

Other models: CMS-HCC V22 HCC 186 · RxHCC V08 HCC 395

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for M31.11 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on M31.11 itself; “inherited from” names the category or block whose note applies here.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • autoimmune disease NOS
  • collagen (vascular) disease NOS
  • systemic autoimmune disease
  • systemic collagen (vascular) disease

Source: inherited from M30-M36

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Transplant-associated thrombotic microangiopathy [TA-TMA]

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).

  • autoimmune disease, single organ or single cell-type -code to relevant condition category

Source: inherited from M30-M36

Code First

Underlying conditions that must be sequenced before this code.

  • if applicable:
  • complications of bone marrow transplant (T86.0-)
  • complications of stem cell transplant (T86.5)

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code to identify specific organ dysfunction, such as:
  • acute kidney failure (N17.-)
  • acute respiratory distress syndrome (J80)
  • capillary leak syndrome (I78.8)
  • diffuse alveolar hemorrhage (R04.89)
  • encephalopathy (metabolic) (septic) (G93.41)
  • fluid overload, unspecified (E87.70)
  • graft versus host disease (D89.81-)
  • hemolytic uremic syndrome (D59.3-)
  • hepatic failure (K72.-)
  • hepatic veno-occlusive disease (K76.5)
  • idiopathic interstitial pneumonia (J84.11-)
  • sinusoidal obstruction syndrome (K76.5)

Coder workflow for M31.11

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

Before you code M31.11

  1. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with M31.11. 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 M31.11’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.
  2. Is the underlying (etiologic) condition the Code First note names documented?
    Yes → Sequence the underlying condition first, then M31.11.
    No → Continue; do not add an underlying condition the record does not document.

    ReviewT86.0, T86.5

Consider M31.11. 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 M31.11(1 note)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with M31.11: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    See the official tabular notes · Guidelines I.A.12.a

  • 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 M31.11. Do not add an underlying condition the record does not document.

    ReviewT86.0, T86.5

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

  • Use Additional Code — after identifying M31.11(13 notes)

    Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with M31.11 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.

    ReviewN17, J80, I78.8, R04.89, G93.41, E87.70

    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 M31.11 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).

ReviewT86.0, T86.5

Documentation: A condition the Use Additional Code note names is documented.

Coding question: Is a second code reported with M31.11?

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).

ReviewN17, J80, I78.8, R04.89, G93.41, E87.70

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.

Don’t confuse M31.11 with…

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

The codes most likely to be picked instead of M31.11 — 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.

  • M31.10— 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 “Thrombotic microangiopathy, unspecified” takes M31.10; specificity in the record moves it back here.

    Full comparison: M31.11 vs M31.10 →

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.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Hematopoietic stem cell transplantation-associated thrombotic microangiopathy [HSCT-TMA] is a billable ICD-10-CM diagnosis code (M31.11).

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.

  1. Sequencing: 3 Code First instructions — the underlying condition is sequenced before this code when present. See the Code First notes
  2. 13 Use Additional Code instructions — report the named additional code(s) when the documentation supports them. See the Use Additional Code notes
  3. 1 Excludes1 entry — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 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

  • MCC as a secondary diagnosis (FY2027). 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-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name M31.11 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: L94 — Other localized connective tissue disorders (via M31.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 2 Excludes2 notes across 2 chapters: I77 — Other disorders of arteries and arterioles (via M31.-), J82 — Pulmonary eosinophilia, not elsewhere classified (via M31.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Referenced by 1 Code First instruction: J84.170 — Interstitial lung disease with progressive fibrotic phenotype in diseases classified elsewhere (via M31.-).

Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: MCC — Major 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 25 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 3 MS-DRGs: DRG 545 (MDC 08), DRG 546 (MDC 08), DRG 547 (MDC 08).

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

Clinical classification (AHRQ CCSR):INJ036 — Complication of transplanted organs or tissue, initial encounter (default); CIR037 — Vasculitis; MUS024 — Systemic lupus erythematosus and connective tissue disorders.

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 MCC — 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.

E11.51 — Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene, E11.52 — Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene, E13.51 — Other specified diabetes mellitus with diabetic peripheral angiopathy without gangrene, E13.52 — Other specified diabetes mellitus with diabetic peripheral angiopathy with gangrene, I27.841 — Fontan-associated lymphatic dysfunction, I27.848 — Other Fontan-associated condition, I27.849 — Fontan related circulation, unspecified, I99.8 — Other disorder of circulatory system, I99.9 — Unspecified disorder of circulatory system, M30.0 — Polyarteritis nodosa, M30.1 — Polyarteritis with lung involvement [Churg-Strauss], M30.2 — Juvenile polyarteritis, M30.3 — Mucocutaneous lymph node syndrome [Kawasaki], M30.8 — Other conditions related to polyarteritis nodosa, M31.0 — Hypersensitivity angiitis, M31.10 — Thrombotic microangiopathy, unspecified, M31.19 — Other thrombotic microangiopathy, M31.5 — Giant cell arteritis with polymyalgia rheumatica, M31.6 — Other giant cell arteritis, M31.7 — Microscopic polyangiitis, +4 more

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, D89.811 — Chronic graft-versus-host disease, D89.812 — Acute on chronic graft-versus-host disease, D89.813 — Graft-versus-host disease, unspecified, 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 (Complication of transplanted organs or tissue, initial encounter, Vasculitis, Systemic lupus erythematosus and connective tissue disorders).

M05.279 — Rheumatoid vasculitis with rheumatoid arthritis of unspecified ankle and foot, M05.29 — Rheumatoid vasculitis with rheumatoid arthritis of multiple sites, M30.0 — Polyarteritis nodosa, M30.1 — Polyarteritis with lung involvement [Churg-Strauss], M30.2 — Juvenile polyarteritis, M30.3 — Mucocutaneous lymph node syndrome [Kawasaki], M30.8 — Other conditions related to polyarteritis nodosa, M31.0 — Hypersensitivity angiitis, M31.1 — Thrombotic microangiopathy, M31.10 — Thrombotic microangiopathy, unspecified, M31.19 — Other thrombotic microangiopathy, M31.2 — Lethal midline granuloma, M31.30 — Wegener's granulomatosis without renal involvement, M31.31 — Wegener's granulomatosis with renal involvement, M31.4 — Aortic arch syndrome [Takayasu], M31.5 — Giant cell arteritis with polymyalgia rheumatica, M31.6 — Other giant cell arteritis, M31.7 — Microscopic polyangiitis, M31.8 — Other specified necrotizing vasculopathies, M31.9 — Necrotizing vasculopathy, unspecified, +197 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Microangiopathy”; these codes share that main term but sit in a different category of the Tabular List.

I73.9 — Peripheral vascular disease, unspecified

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

HIV Screening Test, Partial Thromboplastin Time (PTT) Test

Contextual Map

Every relationship of M31.11 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 M31.11 with these 14 related codes in Claim Check

Hierarchy

Code First

Use Additional Code (11)

Referenced by Excludes1 notes

Referenced by Excludes2 notes

Referenced by Code First instructions

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

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

MS-DRG Grouper

MDC crossing

  • MDC 08 — Diseases and Disorders of the Musculoskeletal System and Connective Tissue[MDC crossing]: “Diseases and Disorders of the Musculoskeletal System and Connective Tissue — 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. 18,439 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027

Index entries

  • HSCT-TMA (hematopoietic stem cell transplantation-associated thrombotic microangiopathy)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Microangiopathy (peripheral), thrombotic, hematopoietic stem cell transplantation-associated [HSCT-TMA][Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027

Nearest codes (15)

Change history

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Indexed Clinical Terms (2)

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.

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 FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 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 — v44 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-derived 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 editorial 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.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

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. "M31.11 — Hematopoietic stem cell transplantation-associated thrombotic microangiopathy [HSCT-TMA]." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/m31.11-hematopoietic-stem-cell-transplantation-associated-thrombotic-microangiopathy-hsct-tma

Change history

  • FY2022 — October 1, 2021
    Added to the code set
    Hematopoietic stem cell transplantation-associated thrombotic microangiopathy [HSCT-TMA]
    FY2022 changes

Nearest Codes in This Family

Official ICD-10-CM classifications closest to M31.11 in its code family, with their registry titles.

View all codes in the M31 family