I27.83: Eisenmenger's syndrome
I27.83 is a billable, specific ICD-10-CM code for eisenmenger's syndrome. It is valid for submission on a claim.
Check I27.83 with the rest of the claim: free scrubberCode also
Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Eisenmenger's complex
- (Irreversible) Eisenmenger's disease
- Pulmonary hypertension with right to left shunt related to congenital heart disease
Other codes that can never be billed with I27.83
Their own Excludes1 notes name this code, so the conflict is not listed above.
- I27.2Other secondary pulmonary hypertension
Risk adjustment
I27.83 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 226 Heart Failure, Except End Stage and Acute0.360 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
I27.83 is named in 22 Medicare coverage policies: 22 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52466Nebulizers - Policy Article
- A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
- A53026Billing and Coding: Bariatric Surgery Coverage
- A56423Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing
Alphabetic index entries that lead here
- Complex›Eisenmenger's(ventricular septal defect)
- Disease, diseased›Eisenmenger's(irreversible)
- Eisenmenger's›complex or syndrome
- Syndrome›Eisenmenger's
- Hypertension, hypertensive›pulmonary›with›right to left shunt related to congenital heart disease
Code history
Unchanged in every release from FY2024 to FY2027.