I42.6 — Alcoholic cardiomyopathy
I42.6 is a billable, specific ICD-10-CM code for alcoholic cardiomyopathy. It is valid for submission on a claim.
Code also
Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.
- presence of alcoholism (F10.-)
Risk adjustment
I42.6 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.
Medicare coverage
I42.6 is named in 36 Medicare coverage policies — 36 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52458Automatic External Defibrillators - Policy Article
- A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
- A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
- A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
How I42.6 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 I42.6.
- Beer drinker's heart(disease)
- Alcohol, alcoholic, alcohol-induced›cardiopathy
- Cardiomyopathy›alcoholic
- Cardiomyopathy›cobalt-beer
- Myocardiopathy›alcoholic
- Myocardiopathy›cobalt-beer
- Cardiomyopathy›due to›alcohol
- Disease, diseased›heart›beer drinkers'
Related codes at this level
Codes that share I42. If I42.6 is not quite right, the correct code is usually one of these.
- I42.0Dilated cardiomyopathy
- I42.1Obstructive hypertrophic cardiomyopathy
- I42.2Other hypertrophic cardiomyopathy
- I42.3Endomyocardial (eosinophilic) disease
- I42.4Endocardial fibroelastosis
- I42.5Other restrictive cardiomyopathy
- I42.7Cardiomyopathy due to drug and external agent
- I42.8Other cardiomyopathies
- I42.9Cardiomyopathy, unspecified
Questions about I42.6
- Is I42.6 a billable ICD-10-CM code?
- Yes. I42.6 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does I42.6 sit in the tabular list?
- Diseases of the circulatory system (I00-I99), in the block Other forms of heart disease (I30-I5A).