I28.0
I28.0: Arteriovenous fistula of pulmonary vessels
Billable / specific codeICD-10-CM
I28.0 is a billable, specific ICD-10-CM code for arteriovenous fistula of pulmonary vessels. It is valid for submission on a claim.
Check I28.0 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- congenital arteriovenous fistula (Q25.72)
Risk adjustment
I28.0 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
I28.0 is named in 13 Medicare coverage policies: 13 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
- A52868Billing and Coding: Transesophageal Echocardiography (TEE)
- A56500Billing and Coding: Cardiac Catheterization and Coronary Angiography
- A56505Billing and Coding: Transesophageal Echocardiography (TEE)
Alphabetic index entries that lead here
- Shunt›arteriovenous, pulmonary(acquired)
- Fistula›arteriovenous›pulmonary
- Fistula›pulmonary›arteriovenous
- Aneurysm›arteriovenous›acquired›pulmonary
- Aneurysm›pulmonary›arteriovenous›acquired
Code history
Unchanged in every release from FY2024 to FY2027.