I26
I26: Pulmonary embolism
Non-billable headerICD-10-CM
I26 is a non-billable header ICD-10-CM code for pulmonary embolism. It cannot be billed on its own: choose one of the more specific child codes below.
Excludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- cor pulmonale without embolism (I27.81)
Excludes2: not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
- chronic pulmonary embolism (I27.82)
- personal history of pulmonary embolism (Z86.711)
- pulmonary embolism complicating abortion, ectopic or molar pregnancy (O00-O07, O08.2)
- pulmonary embolism complicating pregnancy, childbirth and the puerperium (O88.-)
- pulmonary embolism due to trauma (T79.0, T79.1)
- pulmonary embolism due to complications of surgical and medical care (T80.0, T81.7-, T82.8-)
- septic (non-pulmonary) arterial embolism (I76)
Includes
Conditions this code covers.
- pulmonary (acute) (artery)(vein) infarction
- pulmonary (acute) (artery)(vein) thromboembolism
- pulmonary (acute) (artery)(vein) thrombosis
Other codes that can never be billed with I26
Their own Excludes1 notes name this code, so the conflict is not listed above.
- I27.81Cor pulmonale (chronic)
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Code history
Unchanged in every release from FY2024 to FY2027.
Code to one of these instead I26
2 child codes. Green means billable.