I26.94 — Multiple subsegmental thrombotic pulmonary emboli without acute cor pulmonale
I26.94 is a billable, specific ICD-10-CM code for multiple subsegmental thrombotic pulmonary emboli without acute cor pulmonale. It is valid for submission on a claim.
Risk adjustment
I26.94 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
I26.94 is named in 39 Medicare coverage policies — 39 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- 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
How I26.94 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 I26.94.
- Embolism›pulmonary›multiple subsegmental without acute cor pulmonale
Related codes at this level
Codes that share I26.9. If I26.94 is not quite right, the correct code is usually one of these.
- I26.90Septic pulmonary embolism without acute cor pulmonale
- I26.92Saddle embolus of pulmonary artery without acute cor pulmonale
- I26.93Single subsegmental thrombotic pulmonary embolism 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
Questions about I26.94
- Is I26.94 a billable ICD-10-CM code?
- Yes. I26.94 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does I26.94 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).