I28.9: Disease of pulmonary vessels, unspecified

Risk adjustment

I28.9 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

I28.9 is named in 4 Medicare coverage policies: 4 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

• A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
• A56500Billing and Coding: Cardiac Catheterization and Coronary Angiography
• A56625Billing and Coding: Echocardiography
• A56691Billing and Coding: Cardiac Computed Tomography & Angiography (CCTA)