Is I26.9 a billable ICD-10-CM code?

No. I26.9 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does I26.9 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).

What cannot be coded together with I26.9?

I26.9 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above I26.9 (I26) and apply to it just the same.

I26.9

I26.9 — Pulmonary embolism without acute cor pulmonale

Non-billable headerICD-10-CM

I26.9 is a non-billable header ICD-10-CM code for pulmonary embolism without acute cor pulmonale. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1 inherited from the categories above I26.9

These are not written on I26.9, but they bind it: a note on a category applies to every code beneath it. Billing I26.9 with anything listed here is a denial.

Written on I26 — Pulmonary embolism

cor pulmonale without embolism (I27.81)

Excludes2 inherited from the categories above I26.9

Also inherited, and the opposite of Excludes1: these conditions are not part of I26.9, but a patient can have both, so you may code both.

Written on I26 — Pulmonary embolism

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)

Risk adjustment

I26.9 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Code history

I26.9 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Code to one of these instead I26.9

7 child codes. Green means billable.

Related codes at this level

Codes that share I26. If I26.9 is not quite right, the correct code is usually one of these.

I26.0Pulmonary embolism with acute cor pulmonale

Questions about I26.9

Is I26.9 a billable ICD-10-CM code?: No. I26.9 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does I26.9 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).
What cannot be coded together with I26.9?: I26.9 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above I26.9 (I26) and apply to it just the same.