I51.2: Rupture of papillary muscle, not elsewhere classified
I51.2 is a billable, specific ICD-10-CM code for rupture of papillary muscle, not elsewhere classified. It is valid for submission on a claim.
Check I51.2 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- rupture of papillary muscle as current complication following acute myocardial infarction (I23.5)
Other codes that can never be billed with I51.2
Their own Excludes1 notes name this code, so the conflict is not listed above.
- I23.5Rupture of papillary muscle as current complication following acute myocardial infarction
Risk adjustment
I51.2 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 229 Unstable Angina and Other Acute Ischemic Heart Disease0.240 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
I51.2 is named in 12 Medicare coverage policies: 12 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
- A52868Billing and Coding: Transesophageal Echocardiography (TEE)
- A56476Billing and Coding: Cardiac Radionuclide Imaging
- A56500Billing and Coding: Cardiac Catheterization and Coronary Angiography
Alphabetic index entries that lead here
- Rupture, ruptured›papillary muscle NEC
Code history
Unchanged in every release from FY2024 to FY2027.