Pulmonary Embolism ICD-10-CM Codes

What ICD-10 Codes are Used for Pulmonary Embolism 

ICD-10 codes are alphanumeric codes used in medical billing to categorize diseases and conditions. For pulmonary embolism, specific codes are used to document and bill for this serious condition. It results from a blood clot traveling to the lungs from deep veins in the legs, causing potentially life-threatening blockages. Here are commonly used Pulmonary Embolism ICD Codes, along with their clinical descriptions:

• I26.0 - Pulmonary Embolism with Acute Cor Pulmonale: This code indicates a pulmonary embolism that causes acute cor pulmonale, a condition characterized by right-sided heart failure due to increased pressure in the pulmonary arteries.
• I26.9 - Pulmonary Embolism without Mention of Acute Cor Pulmonale: This code is used when a pulmonary embolism occurs without causing acute cor pulmonale.
• I26.90 - Saddle Embolus of Pulmonary Artery without Mention of Acute Cor Pulmonale: This code is used when a large blood clot, also known as a saddle embolus, lodges at the bifurcation of the main pulmonary artery, without causing acute cor pulmonale.
• I26.92 - Other Pulmonary Embolism without Mention of Acute Cor Pulmonale: This code is utilized when a pulmonary embolism occurs in other parts of the pulmonary artery, not at the bifurcation, and without causing acute cor pulmonale.
• I26.99 - Other Pulmonary Embolism with Mention of Acute Cor Pulmonale: This code is used when a pulmonary embolism occurs, and there is mention of acute cor pulmonale, but specific details about the location of the embolism are not provided.
• I26.A - Septic Pulmonary Embolism: This code is used when a pulmonary embolism is caused by infected material, such as a septic thrombus, traveling through the bloodstream to the lungs.
• I26.01 - Saddle Embolus of Pulmonary Artery with Acute Cor Pulmonale: This code is used when a large blood clot lodges at the bifurcation of the main pulmonary artery, leading to acute cor pulmonale.
• I26.8 - Other Pulmonary Embolism with Acute Cor Pulmonale: This code is used for cases of pulmonary embolism that cause acute cor pulmonale but do not fit the descriptions provided by other specific codes.

Healthcare providers use these ICD-10 codes to document and bill for pulmonary embolism cases accurately. Proper coding ensures appropriate reimbursement and helps maintain accurate medical records, vital for patient care and research.

Here's an explainer video that further clarifies the concept of pulmonary embolism and its associated ICD-10 codes:

Which Pulmonary Embolism ICD codes are Billable

Here are the commonly used ICD-10 codes for pulmonary embolism, along with their billable status:

1. I26.0 - Pulmonary Embolism with Acute Cor Pulmonale: Yes
2. I26.9 - Pulmonary Embolism without Mention of Acute Cor Pulmonale: Yes
3. I26.90 - Saddle Embolus of Pulmonary Artery without Mention of Acute Cor Pulmonale: Yes
4. I26.92 - Other Pulmonary Embolism without Mention of Acute Cor Pulmonale: Yes
5. I26.99 - Other Pulmonary Embolism with Mention of Acute Cor Pulmonale: Yes
6. I26.A - Septic Pulmonary Embolism: Yes
7. I26.01 - Saddle Embolus of Pulmonary Artery with Acute Cor Pulmonale: Yes
8. I26.8 - Other Pulmonary Embolism with Acute Cor Pulmonale: Yes

All the listed codes for pulmonary embolism are billable and can be used for medical billing and coding purposes. Properly assigning the appropriate ICD-10 code is essential for accurate documentation and billing of pulmonary embolism cases.

Clinical Information

• Pulmonary Embolism (PE) is a serious medical condition where a blood clot, typically originating from the deep veins of the legs (deep vein thrombosis), travels to the lungs and causes a blockage in one of the pulmonary arteries.
• The blockage disrupts blood flow, reducing oxygen supply to the lungs and potentially to other vital organs.
• Common risk factors for PE include prolonged immobility (e.g., bed rest, long journeys), recent surgery, trauma, cancer, pregnancy, smoking, and a history of blood clots.
• Symptoms of PE can vary but may include sudden onset of chest pain, shortness of breath, rapid or irregular heartbeat, coughing up blood (hemoptysis), and anxiety.
• PE can range from mild to life-threatening, and prompt diagnosis and treatment are crucial to prevent complications like pulmonary infarction, right-sided heart failure, or even death.
• Diagnostic tests for PE may include CT angiography, ventilation-perfusion (V/Q) scan, and D-dimer blood test to detect clot breakdown products.
• Treatment often involves anticoagulant medications (blood thinners) to prevent further clotting and allow the body's natural mechanisms to dissolve the clot over time.
• In severe cases or when anticoagulants are contraindicated, clot-dissolving medications (thrombolytics) or surgical procedures like thrombectomy may be necessary to remove the clot.
• Patients with a history of PE may require long-term anticoagulation therapy to prevent recurrence.
• Prevention strategies include early ambulation after surgery, compression stockings during prolonged immobility use, and prophylactic anticoagulation in high-risk individuals.

Synonyms Include

• Pulmonary thromboembolism
• PE
• Lung embolism
• Pulmonary artery embolism
• Pulmonary blood clot
• Lung clot
• Pulmonary vascular occlusion
• Obstruction of pulmonary artery
• Pulmonary embolic event