T86.30: Unspecified complication of heart-lung transplant

T86.30, unspecified complication of heart-lung transplant, is listed as a covered diagnosis in 8 Medicare billing and coding articles that apply to 94 HCPCS Level II codes, including Q0512 (Pharmacy supply fee for oral anti-cancer, oral anti-emetic…), Q0511 (Pharmacy supply fee for oral anti-cancer, oral anti-emetic…), J7510 (Prednisolone oral, per 5 mg). 20 of these codes have a 2026 DMEPOS fee schedule amount; K0730 pays $245.69 (RR) depending on the state. The articles come from 3 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.

HCPCS Level II codes with T86.30 as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
Q0512Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day periodSpecial coverage instructions apply—1
Q0511Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day periodSpecial coverage instructions apply—1
J7510Prednisolone oral, per 5 mgSpecial coverage instructions apply—1
Q0510Pharmacy supply fee for initial immunosuppressive drug(s), first month following transplantSpecial coverage instructions apply—1
J7599Immunosuppressive drug, not otherwise classifiedSpecial coverage instructions apply—1
A9500Technetium tc-99m sestamibi, diagnostic, per study doseCarrier judgment—2
A9502Technetium tc-99m tetrofosmin, diagnostic, per study doseCarrier judgment—2
A9505Thallium tl-201 thallous chloride, diagnostic, per millicurieCarrier judgment—2
A9501Technetium tc-99m teboroxime, diagnostic, per study doseCarrier judgment—2
J0461Injection, atropine sulfate, 0.01 mgSpecial coverage instructions apply—3
J0153Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds)Special coverage instructions apply—3
J1250Injection, dobutamine hydrochloride, per 250 mgSpecial coverage instructions apply—3
J0280Injection, aminophyllin, up to 250 mgSpecial coverage instructions apply—3
J1245Injection, dipyridamole, per 10 mgSpecial coverage instructions apply—3
A9512Technetium tc-99m pertechnetate, diagnostic, per millicurieCarrier judgment—1
A9560Technetium tc-99m labeled red blood cells, diagnostic, per study dose, up to 30 millicuriesCarrier judgment—1
A9538Technetium tc-99m pyrophosphate, diagnostic, per study dose, up to 25 millicuriesCarrier judgment—1
A9520Technetium tc-99m tilmanocept, diagnostic, up to 0.5 millicuriesCarrier judgment—1
C9176Tc-99m from domestically produced non-heu mo-99, [minimum 50 percent], full cost recovery add-on, per study doseSpecial coverage instructions apply—1
K0730Controlled dose inhalation drug delivery systemCarrier judgment$245.69 (RR)1
E1372Immersion external heater for nebulizerSpecial coverage instructions apply$136.61–$208.94 (NU)1
A7017Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygenSpecial coverage instructions apply$130.82–$194.58 (NU)1
E0580Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeterSpecial coverage instructions apply$164.65–$182.27 (NU)1
E0575Nebulizer, ultrasonic, large volumeSpecial coverage instructions apply$124.51–$159.48 (RR)1
E0565Compressor, air power source for equipment which is not self-contained or cylinder drivenCarrier judgment$42.74–$82.96 (RR)1

69 more codes are listed. See every code with payment by region in Caduvo.

Medicare policy articles listing T86.30

A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.

Other T86 diagnoses (Complications of transplanted organs and tissue)

Frequently asked questions

Does Medicare cover T86.30 (Unspecified complication of heart-lung transplant)?

Medicare covers items and services, not diagnoses. 8 Medicare billing and coding articles list T86.30 as a covered diagnosis for 94 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.

Which HCPCS codes can be billed with ICD-10 T86.30?

The Level II codes from the policies most specific to this diagnosis are Q0512 (Pharmacy supply fee for oral anti-cancer, oral anti-emetic…, 1 article); Q0511 (Pharmacy supply fee for oral anti-cancer, oral anti-emetic…, 1 article); J7510 (Prednisolone oral, per 5 mg, 1 article); Q0510 (Pharmacy supply fee for initial immunosuppressive drug(s)…, 1 article); J7599 (Immunosuppressive drug, not otherwise classified, 1 article). Code choice depends on the item supplied; check each code's descriptor.

What does Medicare pay for equipment billed with T86.30?

Under the 2026 DMEPOS fee schedule (non-rural state fees): K0730 $245.69 (RR); E1372 $136.61 to $208.94 (NU); A7017 $130.82 to $194.58 (NU); E0580 $164.65 to $182.27 (NU). Medicare pays 80% of the allowed amount after the Part B deductible.

Which Medicare policy articles list T86.30?

A52474 (Immunosuppressive Drugs - Policy Article); A56743 (Billing and Coding: Cardiovascular Nuclear Medicine); A52466 (Nebulizers - Policy Article), and 5 more articles.

What is ICD-10-CM code T86.30?

T86.30 is the ICD-10-CM code for unspecified complication of heart-lung transplant, in category T86 (Complications of transplanted organs and tissue), chapter 19: Injury, poisoning and other consequences of external causes.

Next steps

Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.

Chapter 19: Injury, poisoning and other consequences of external causes · All diagnoses · HCPCS lookup