I42.0
I42.0: Dilated cardiomyopathy
Non-billable headerICD-10-CM
I42.0 is a non-billable header ICD-10-CM code for dilated cardiomyopathy. It cannot be billed on its own: choose one of the more specific child codes below.
Risk adjustment
I42.0 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 227 Cardiomyopathy/Myocarditis0.189 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
I42.0 is named in 2 Medicare coverage policies: 2 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A59960Billing and Coding: B-type Natriuretic Peptide (BNP) Testing
- A60292Billing and Coding: Temporary Nontherapeutic Ambulatory Cardiac Monitoring Devices
Code history
- deletedFY2024-FY2027
Dilated cardiomyopathy
Code to one of these instead I42.0
3 child codes. Green means billable.
Other codes under I42
- I42.1Obstructive hypertrophic cardiomyopathy
- I42.2Other hypertrophic cardiomyopathy
- I42.3Endomyocardial (eosinophilic) disease
- I42.4Endocardial fibroelastosis
- I42.5Other restrictive cardiomyopathy
- I42.6Alcoholic cardiomyopathy
- I42.7Cardiomyopathy due to drug and external agent
- I42.8Other cardiomyopathies
- I42.9Cardiomyopathy, unspecified