I42.6

I42.6: Alcoholic cardiomyopathy

Billable / specific codeICD-10-CM

I42.6 is a billable, specific ICD-10-CM code for alcoholic cardiomyopathy. It is valid for submission on a claim.

Check I42.6 with the rest of the claim: free scrubber

Code also

Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.

presence of alcoholism (F10.-)

Excludes2 inherited from the categories above I42.6

Not part of this code, but both may be coded when both are present.

Written on I42: Cardiomyopathy

ischemic cardiomyopathy (I25.5)
peripartum cardiomyopathy (O90.3)
ventricular hypertrophy (I51.7)

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. Look up the whole chart to see which of its HCCs the hierarchy would zero.

Medicare coverage

I42.6 is named in 25 Medicare coverage policies: 25 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A52458Automatic External Defibrillators - Policy Article
A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
A52868Billing and Coding: Transesophageal Echocardiography (TEE)
A56391Billing and Coding: Implantable Automatic Defibrillators

Alphabetic index entries that lead here

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'

Code history

Unchanged in every release from FY2024 to FY2027.