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ICD-10 Guide
ICD-10 CodesI27.8

I27.8

Non-billable

Other specified pulmonary heart diseases

BILLABLE STATUSNo
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 I27.8 is a used to indicate a diagnosis of other specified pulmonary heart diseases.

Key Diagnostic Point:

I27.8 refers to 'Other specified pulmonary heart diseases,' which encompasses a range of conditions affecting the right side of the heart due to pulmonary issues. These conditions can arise from chronic lung diseases, pulmonary hypertension, or other pulmonary vascular disorders that lead to right ventricular hypertrophy and heart failure. Clinically, patients may present with symptoms such as dyspnea, fatigue, chest pain, and signs of right heart failure, including peripheral edema and jugular venous distension. The anatomy involved primarily includes the right ventricle and pulmonary arteries, which are directly affected by increased pressure or volume overload. Disease progression can vary, with some patients experiencing gradual deterioration of cardiac function, while others may have acute exacerbations. Diagnostic considerations include echocardiography, chest imaging, and pulmonary function tests, which help assess the underlying pulmonary conditions contributing to the heart disease. Accurate diagnosis is crucial for effective management and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires understanding of both pulmonary and cardiac conditions.
  • Treatment complexity: Management may involve multiple specialties, including cardiology and pulmonology.
  • Documentation requirements: Detailed clinical documentation is necessary to justify the use of this code.
  • Coding specificity: Requires precise coding to differentiate from other pulmonary heart diseases.

Audit Risk Factors

  • Common coding errors: Misclassification with other pulmonary heart diseases.
  • Documentation gaps: Insufficient clinical details to support the diagnosis.
  • Billing challenges: Potential for denials if documentation does not clearly establish the condition.

Specialty Focus

Medical Specialties

Cardiology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Pulmonology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of I27.8 lies in its association with chronic pulmonary conditions that can lead to significant morbidity and mortality. Understanding and accurately coding these conditions can improve population health outcomes by ensuring that patients receive appropriate management and follow-up. Quality measures may include monitoring for exacerbations of heart failure and pulmonary disease, which can impact healthcare utilization patterns and resource allocation.

ICD-9 vs ICD-10

The clinical significance of I27.8 lies in its association with chronic pulmonary conditions that can lead to significant morbidity and mortality. Understanding and accurately coding these conditions can improve population health outcomes by ensuring that patients receive appropriate management and follow-up. Quality measures may include monitoring for exacerbations of heart failure and pulmonary disease, which can impact healthcare utilization patterns and resource allocation.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the diagnosis is clearly linked to the services provided. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Coders should ensure that all relevant clinical details are included in the medical record to support the use of this code and facilitate appropriate reimbursement.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for I00-I99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for I00-I99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by I27.8?

I27.8 includes conditions such as pulmonary hypertension not classified elsewhere, chronic obstructive pulmonary disease (COPD) with cor pulmonale, and other specified pulmonary heart diseases that do not fall under more specific codes.

When should I27.8 be used instead of related codes?

I27.8 should be used when the pulmonary heart disease does not fit the criteria for more specific codes like I27.0 or I27.1, and when the underlying pulmonary condition is documented but not specified.

What documentation supports I27.8?

Documentation should include a thorough clinical evaluation, diagnostic imaging results, pulmonary function tests, and any relevant laboratory findings that support the diagnosis of pulmonary heart disease.