I42.7

I42.7: Cardiomyopathy due to drug and external agent

Billable / specific codeICD-10-CM

I42.7 is a billable, specific ICD-10-CM code for cardiomyopathy due to drug and external agent. It is valid for submission on a claim.

Check I42.7 with the rest of the claim: free scrubber

Code first

The underlying condition must be sequenced before this code.

poisoning due to drug or toxin, if applicable (T36-T65 with fifth or sixth character 1-4)

Use additional code

Add a secondary code to capture the detail described below.

code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)

Excludes2 inherited from the categories above I42.7

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

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

I42.7 is named in 26 Medicare coverage policies: 26 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

Cardiomyopathy›toxic NEC
Myocardiopathy›toxic NEC
Cardiomyopathy›due to›drugs
Cardiomyopathy›due to›external agents NEC

Code history

Unchanged in every release from FY2024 to FY2027.