Post-transplant lymphoproliferative disorder (PTLD)

This code identifies a serious complication that can occur after solid organ or hematopoietic stem cell transplantation. PTLD is a heterogeneous group of lymphoproliferative disorders, ranging from benign polyclonal hyperplasia to aggressive lymphoma, arising as a consequence of immunosuppression in transplant recipients. It is often associated with Epstein-Barr virus (EBV) infection.

Assign this code for any confirmed diagnosis of PTLD in a patient who has undergone a transplant. Documentation should clearly state the diagnosis of PTLD, often supported by biopsy results and clinical presentation. This code is appropriate regardless of the specific subtype or severity of the PTLD.

• Always sequence this code as a primary diagnosis when PTLD is the reason for the encounter.
• Code any associated complications or manifestations of PTLD, such as specific organ involvement, as secondary diagnoses.
• Ensure documentation specifies a transplant history; otherwise, consider other lymphoproliferative disorder codes if no transplant is indicated.