I26.09 — Other pulmonary embolism with acute cor pulmonale
I26.09 is a billable, specific ICD-10-CM code for other pulmonary embolism with acute cor pulmonale. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Acute cor pulmonale NOS
- Other thrombotic pulmonary embolism with acute cor pulmonale
Risk adjustment
I26.09 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 267 Deep Vein Thrombosis and Pulmonary Embolism0.294 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
I26.09 is named in 40 Medicare coverage policies — 40 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
- A52868Billing and Coding: Transesophageal Echocardiography (TEE)
- A52993Billing and Coding: Peripheral Venous Ultrasound
- A56476Billing and Coding: Cardiac Radionuclide Imaging
How I26.09 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to I26.09.
- Cor›pulmonale›acute
- Embolism›pulmonary›with acute cor pulmonale
- Embolism›thrombotic›specified NEC›with acute cor pulmonale
- Hypertension, hypertensive›pulmonary›with›cor pulmonale›acute
- Hypertension, hypertensive›pulmonary›with›right heart ventricular strain/failure›acute
Related codes at this level
Codes that share I26.0. If I26.09 is not quite right, the correct code is usually one of these.
Questions about I26.09
- Is I26.09 a billable ICD-10-CM code?
- Yes. I26.09 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does I26.09 sit in the tabular list?
- Diseases of the circulatory system (I00-I99), in the block Pulmonary heart disease and diseases of pulmonary circulation (I26-I28).