I26.93: Single subsegmental thrombotic pulmonary embolism without acute cor pulmonale
I26.93 is a billable, specific ICD-10-CM code for single subsegmental thrombotic pulmonary embolism without acute cor pulmonale. It is valid for submission on a claim.
Check I26.93 with the rest of the claim: free scrubberInclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Subsegmental pulmonary embolism NOS
Excludes1 inherited from the categories above I26.93
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above I26.93
Not part of this code, but both may be coded when both are present.
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
I26.93 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
I26.93 is named in 34 Medicare coverage policies: 34 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52868Billing and Coding: Transesophageal Echocardiography (TEE)
- A52993Billing and Coding: Peripheral Venous Ultrasound
- A56476Billing and Coding: Cardiac Radionuclide Imaging
- A56500Billing and Coding: Cardiac Catheterization and Coronary Angiography
Alphabetic index entries that lead here
- Embolism›pulmonary›single subsegmental without acute cor pulmonale
- Embolism›pulmonary›subsegmental NOS
Code history
- revisedFY2024-FY2027
Single subsegmental pulmonary embolism without acute cor pulmonale → Single subsegmental thrombotic pulmonary embolism without acute cor pulmonale
Other codes under I26.9
- I26.90Septic pulmonary embolism without acute cor pulmonale
- I26.92Saddle embolus of pulmonary artery without acute cor pulmonale
- I26.94Multiple subsegmental thrombotic pulmonary emboli without acute cor pulmonale
- I26.95Cement embolism of pulmonary artery without acute cor pulmonale
- I26.96Fat embolism of pulmonary artery without acute cor pulmonale
- I26.99Other pulmonary embolism without acute cor pulmonale