Is I26.96 a billable ICD-10-CM code?

Yes. I26.96 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does I26.96 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).

I26.96

I26.96 — Fat embolism of pulmonary artery without acute cor pulmonale

Billable / specific codeICD-10-CM

I26.96 is a billable, specific ICD-10-CM code for fat embolism of pulmonary artery without acute cor pulmonale. It is valid for submission on a claim.

Code first

The underlying condition must be sequenced before this code.

, if applicable:
complication of other artery following a procedure (T81.718)
traumatic fat embolism (T79.1)

Risk adjustment

I26.96 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

I26.96 is named in 30 Medicare coverage policies — 30 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A52993Billing and Coding: Peripheral Venous Ultrasound
A56476Billing and Coding: Cardiac Radionuclide Imaging
A56500Billing and Coding: Cardiac Catheterization and Coronary Angiography
A56500Billing and Coding: Cardiac Catheterization and Coronary Angiography

How I26.96 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 I26.96.

Embolism›fat›pulmonary artery
Embolism›pulmonary›fat

Related codes at this level

Codes that share I26.9. If I26.96 is not quite right, the correct code is usually one of these.

Questions about I26.96

Is I26.96 a billable ICD-10-CM code?: Yes. I26.96 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does I26.96 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).