Pulmonary heart disease and diseases of pulmonary circulation
ICD-10 Codes (21)
I27I27.0I27.1I27.2I27.20I27.21I27.22I27.23I27.24I27.29I27.8I27.81I27.82I27.83I27.89I27.9I28I28.0I28.1I28.8I28.9Updates & Changes
FY 2026 Updates
New Codes (1)
Revised Codes (2)
Deleted Codes
No codes deleted in this range for FY 2026
Historical Changes
- •FY 2025: Routine maintenance updates with minor terminology clarifications
- •FY 2024: Enhanced specificity requirements for certain code ranges
- •FY 2023: Updated documentation guidelines for improved clarity
Upcoming Changes
- •Proposed updates pending review by Coordination and Maintenance Committee
- •Under consideration: Enhanced digital health integration codes
Implementation Guidance
- •Review all FY 2026 updates for I26-I28 codes before implementation
- •Always verify the most current codes in the ICD-10-CM manual
- •Ensure clinical documentation supports the selected diagnosis codes
- +3 more guidance items...
Range Overview
The I26-I28 category in ICD-10 covers codes related to pulmonary heart diseases and diseases of pulmonary circulation. These codes are used to document conditions such as pulmonary embolism, pulmonary hypertension, and other diseases affecting the pulmonary circulation. The codes in this category are essential for accurate medical documentation and billing, and they provide a standardized way to represent these conditions in health records.
Key Usage Points:
- •Always code to the highest level of specificity.
- •Use combination codes when a condition has both an underlying etiology and a manifestation.
- •Assign codes for all documented conditions that coexist at the time of the encounter.
- •Do not code conditions that were previously treated and no longer exist.
- •Follow the Alphabetic Index guidance for sequencing priority.
Coding Guidelines
When to Use:
- ✓When a patient is diagnosed with pulmonary embolism.
- ✓When a patient has chronic pulmonary heart disease.
- ✓When a patient presents with primary pulmonary hypertension.
- ✓When a patient has other diseases of pulmonary vessels.
When NOT to Use:
- ✗When the patient has a heart condition not related to the pulmonary system.
- ✗When the patient has a respiratory condition not affecting the pulmonary circulation.
- ✗When the patient's condition is related to the systemic circulation.
- ✗When the patient's condition is better represented by another code.
Code Exclusions
Always verify the exclusions in the Tabular List before assigning a code.
Documentation Requirements
Proper documentation for I26-I28 codes should include a clear diagnosis, the severity of the condition, any underlying conditions, and any complications. The documentation should be clear, concise, and specific.
Clinical Information:
- •Specific diagnosis
- •Severity of the condition
- •Underlying conditions
- •Complications
Supporting Evidence:
- •Lab results
- •Imaging results
- •Clinical notes
- •Patient history
Good Documentation Example:
Patient diagnosed with chronic thromboembolic pulmonary hypertension. CT scan confirms the diagnosis.
Poor Documentation Example:
Patient has a lung problem.
Common Documentation Errors:
- ⚠Not coding to the highest level of specificity
- ⚠Not documenting underlying conditions
- ⚠Not documenting complications
- ⚠Not providing supporting evidence
Range Statistics
Coding Complexity
The complexity of these codes is considered medium because they require a good understanding of the underlying conditions, the ability to identify the correct level of specificity, the ability to recognize complications, and the ability to follow sequencing rules.
Key Factors:
- ▸Understanding the underlying conditions
- ▸Identifying the correct level of specificity
- ▸Recognizing complications
- ▸Following sequencing rules
Specialty Focus
These codes are primarily used by specialists in cardiology and pulmonology. They are also relevant for general practitioners and emergency medicine physicians.
Primary Specialties:
Clinical Scenarios:
- • A patient with a history of deep vein thrombosis presents with shortness of breath and is diagnosed with pulmonary embolism.
- • A patient with chronic obstructive pulmonary disease (COPD) develops cor pulmonale.
- • A patient presents with unexplained dyspnea and is diagnosed with primary pulmonary hypertension.
- • A patient with a history of pulmonary embolism presents with signs of chronic thromboembolic pulmonary hypertension.
Resources & References
The official ICD-10-CM guidelines, the American Heart Association, and the American Thoracic Society are excellent resources for information on these codes.
Official Guidelines:
- ICD-10-CM Official Guidelines for Coding and Reporting
- American Heart Association
- American Thoracic Society
Clinical References:
Educational Materials:
Frequently Asked Questions
What is the difference between I26 and I27 codes?
I26 codes are used for pulmonary embolism, while I27 codes are used for other pulmonary heart diseases.