ICD code T86.822 – Skin graft infection

Key takeaways

T86.822 covers infection of both allograft (donor) and autograft (patient’s own) skin grafts under ICD-10-CM category T86.

The code is billable at six characters and takes no 7th character, so T86.822A, D or S is an invalid code.

Add a code that specifies the infection, plus a B95-B97 organism code when a culture identifies the organism.

T86.822 is distinct from the T81.4- codes for surgical site infection, so the note must show the graft tissue itself is infected.

ICD-10 code T86.822: Definition and clinical description

ICD-10 code T86.822 is the specific, billable code for an infectious complication of a transplanted skin graft. The CDC/NCHS ICD-10-CM code lookup tool confirms it as valid for the current fiscal year.

The full official descriptor is “Skin graft (allograft) (autograft) infection.” The parentheticals confirm that donor-derived and patient-derived graft tissue fall under the same code.

The code lives in chapter 19 of the ICD-10-CM tabular list, which covers injury, poisoning and certain other consequences of external causes. Within it, T86 is the category for complications of transplanted organs and tissue. It is complete at six characters and takes no 7th character.

That sets it apart from most chapter 19 codes, including the T81.4- surgical site infection codes it is often confused with.

Code details at a glance

The table below summarizes the key administrative attributes of T86.822 as published by CMS in the annual ICD-10-CM release.

Clinical scope: What T86.822 covers

T86.822 applies when a skin graft develops an infectious complication after the graft procedure is complete. It turns up most often in burn reconstruction, post-Mohs repair, chronic wound management in dermatology practices, and reconstructive surgery after trauma or cancer excision.

Common clinical presentations that map to this code include:

• Erythema spreading beyond the graft margin
• Purulent exudate at the graft site
• A wound culture positive for a pathogen
• Systemic signs of infection, such as fever or a raised white blood cell count, in a patient with a recent graft
• A clinical diagnosis of infected graft by the treating provider

The code applies across graft types:

• Split-thickness skin graft (STSG) infection: the most common graft type in burn and trauma reconstruction
• Full-thickness skin graft (FTSG) infection: used in Mohs defect repair and facial reconstruction
• Allograft (cadaveric/donor) infection: temporary biological dressings that develop site infection
• Autograft infection: the patient’s own harvested tissue, infected at the recipient site

Allograft vs. autograft: Does the graft type change the code?

No. Allograft and autograft infections both take T86.822, which is why the official descriptor names both terms in parentheses.

Rejection is the one place the graft type does matter. T86.820 reads “Skin graft (allograft) rejection”, because a patient’s own skin does not trigger rejection. Failure and infection codes cover both graft types.

The allograft and autograft distinction still matters for the operative report and for CPT code selection. Document the graft type in the chart for audit defense, and the diagnosis code stays the same either way.

ICD-10-CM hierarchy: Where T86.822 sits

Understanding the parent hierarchy helps coders navigate the tabular list and confirm the correct level of specificity. The path to T86.822 runs through six levels of the CDC/NCHS ICD-10-CM tabular list. That depth is a US clinical modification, since the WHO’s international ICD-10 stops well short of T86.822.

1. S00-T88 – Injury, Poisoning, and Certain Other Consequences of External Causes (chapter 19)
2. T80-T88 – Complications of surgical and medical care, not elsewhere classified
3. T86 – Complications of transplanted organs and tissue
4. T86.8 – Complications of other transplanted organs and tissues
5. T86.82 – Complications of skin graft (allograft) (autograft)
6. T86.822 – Skin graft (allograft) (autograft) infection

Neighboring codes: T86.820, T86.821, T86.828, and T86.829

All five T86.82x codes cover different types of skin graft complications. Selecting the wrong one is the most common coding error in this group. The table below clarifies when to use each, drawing on the AAPC ICD-10-CM code reference.

How T86.822 differs from T86.820 and T86.821

Rejection (T86.820) is an immune-mediated process. The host’s T-cells recognize the donor graft as foreign and mount an inflammatory response, with no bacterial or fungal pathogen involved. Failure or non-take (T86.821) is a structural problem: the graft does not vascularize or adhere properly.

Neither condition has an infectious cause. Neither should be coded T86.822 unless infection is separately documented alongside the failure or rejection.

Infection (T86.822) requires clinical evidence of a microbial cause: a positive wound culture, documented organisms, or a clinical diagnosis of infection by the treating provider. The chart note must support this distinction, because payers audit the clinical basis for each code in this subcategory.

T86.822 vs. T81.4: Graft infection vs. surgical wound infection

The T81.4- codes (infection following a procedure) are right when the surgical wound itself is infected. T86.822 is correct when the graft tissue is the infected structure. The documentation must name the site of infection, because a code that does not match the note invites a denial.

T81.4 is no longer a billable code on its own. It splits into site-specific codes such as T81.41- (superficial incisional surgical site) and T81.49- (other surgical site), and each one needs a 7th character.

Per ICD-10-CM Official Guidelines, when both a wound infection and a graft infection are documented, report both codes. Sequence them according to the principal reason for the encounter, and do not substitute one for the other. The grid below puts every skin graft scenario in one place.

Does T86.822 need a 7th character?

No. T86.822 is a complete, billable code at six characters, and category T86 has no 7th-character extensions. Appending A, D or S turns it into a code that does not exist, and the claim comes back as an invalid-code rejection.

Most chapter 19 injury codes do take a 7th character, which is why the mistake is so common on T86 claims. Encounter stage is shown by the visit note and by sequencing, not by a suffix. The same T86.822 is reported at the first visit, at dressing changes, and at antibiotic follow-ups while the infection is active.

Late effects work differently. Once the infection has resolved, code the residual condition itself, such as a scar contracture, rather than T86.822.

Additional codes to report alongside T86.822

The ICD-10-CM tabular list places a “use additional code to specify infection” note at T86.822. Report a code that names the infection, and add a B95-B97 organism code after it when the culture identifies the cause.

• B95.61 – MRSA (methicillin-resistant Staphylococcus aureus)
• B95.8 – Unspecified staphylococcus (when culture confirms staph but the species is not reported)
• B96.20 – Unspecified Escherichia coli
• B96.5 – Pseudomonas aeruginosa
• B96.89 – Other specified bacterial agent

If the causative organism is not documented or the culture result is pending, do not add a B95-B97 code. Reporting an organism code without documentation is a compliance risk, not a coding shortcut.

Required clinical documentation

The chart must contain each of the following elements to support T86.822 at audit. A missing element leaves the claim open to recoupment, a risk covered in our guide to medical billing compliance.

• Prior skin graft procedure: confirm the procedure type (STSG, FTSG, allograft) and the date it was performed
• Graft type documentation: specify whether the tissue was allograft or autograft in the operative note or wound care note
• Clinical signs of infection: erythema extending beyond the graft margin, purulent exudate, odor, increased pain, fever, or raised inflammatory markers
• Culture results or clinical diagnosis: a wound culture identifying the organism, or an explicit clinical diagnosis of graft infection by the treating provider
• Provider’s diagnosis: the treating clinician must document “skin graft infection” or an equivalent clinical phrase, because the diagnosis cannot be inferred from signs alone

CPT codes commonly billed with T86.822

T86.822 is an ICD-10-CM diagnosis code. The CPT procedure codes are reported separately and must be medically necessary for the documented graft infection encounter. These encounters typically pair the diagnosis with debridement under CPT 97597, a wound culture, and re-grafting under CPT 15100.

Verify CPT code descriptors against the current AMA CPT code set before billing, as code descriptions and bundling edits change annually.

Common claim denial reasons for T86.822

Claims with ICD-10 code T86.822 are denied more often than the code’s straightforward descriptor suggests. Knowing the pattern lets billing teams catch errors at the claim-building stage rather than the appeals stage. Tracking these patterns is the core of denial management workflows.

• A 7th character appended: the most common technical rejection. T86.822A, T86.822D and T86.822S do not exist, so the claim returns as a front-end invalid-code rejection rather than a clinical denial. Submit T86.822 as is.
• Missing infection or organism code: T86.822 carries a “use additional code to specify infection” note. When the culture has identified the organism, omitting the B95-B97 code invites a medical necessity review at many payers.
• T86.821 or T86.829 submitted instead: coders sometimes assign the unspecified complication code (T86.829) out of caution. Others select T86.821 (failure) when the note says “non-take” alongside documented infection. If infection is documented, T86.822 is the correct code.
• Graft procedure not documented: payers expect to see the original graft procedure, with date and type, in the chart when T86.822 is billed. If the graft was performed at a different facility, retain a copy of that operative note for audit.
• T86.822 used when a T81.4- code applies: the infected structure may be the surgical wound at the donor site. In that case, a T81.4- code fits better. Document which site is infected. Our reference on denial codes in medical billing lists the CARC codes behind these rejections.

Coding tips and best practices

Accurate use of ICD-10 code T86.822 requires coders to verify three source documents before assigning it. They are the operative report confirming the graft procedure and type, the visit note confirming active infection, and any culture or microbiology results.

If you are new to the payer side, our overview of medical billing fundamentals shows how the diagnosis code travels with the claim.

• Sequence as principal diagnosis when graft infection is the reason for the encounter. Sequence it as secondary when the visit is for broader wound care
• Verify graft type from the operative report before coding, because “skin graft” alone in a follow-up note is not sufficient
• Do not substitute T86.829 (unspecified) when infection is documented, since specificity is required whenever the documentation supports it
• Report the same code at follow-up visits while the infection is under treatment. T86.822 carries no encounter character, so the note must show the infection is still active
• Cross-reference the T81.4- guidelines when the documentation is ambiguous about whether the wound or the graft tissue is infected, and query the provider if necessary

How claims management software prevents T86.822 denials

Most T86.822 rejections start as small slips at the billing desk. A suffix gets typed onto the code, an organism code is left off, or the chart has no graft date. Teams usually catch them only when the claim bounces, then re-key the fix by hand.

Pabau, the practice management platform we build, pre-fills each claim from the visit invoice. Its error-checking claims software scrubs every claim for missing or invalid details before it leaves Pabau. If a claim still comes back rejected, Pabau flags it as Needs action and links straight to the field to fix.

For dermatology and plastic surgery practices, graft infection claims go out clean the first time. Your billing team spends its hours on payment follow-up instead of resubmissions.

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Pabau scrubs every claim for missing or invalid details before it leaves Pabau. Each claim is then tracked through to payment.

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Conclusion

T86.822 is one of the simpler codes to get right once you trust the tabular list over habit. Code it at six characters, and pair it with an infection code and the organism when the culture names one.

The judgment call is the infected structure. When the note says graft tissue, T86.822 holds. When it says incision or donor site, a T81.4- code with its 7th character takes over, and a quick provider query beats a guess.

Get those two decisions right and skin graft infection claims stop cycling back as rejections. Book a demo to see how Pabau catches coding errors on graft infection claims before they reach the payer.

Continue your research

Need to understand how clearinghouse validation catches ICD-10 errors before they reach payers? Claim.MD clearinghouse overview explains how real-time scrubbing works for diagnosis and procedure code errors.

Working through a backlog of claim rejections? Electronic remittance advice (ERA) guide covers how to read 835 ERA files and match CARC denial codes to corrective actions.

Want to understand how eligibility verification reduces downstream denials? Insurance eligibility verification guide covers real-time payer checks before the claim is built.

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