2025 ICD-10-CM code I27
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Diseases of the circulatory system - Pulmonary heart disease and diseases of pulmonary circulation Diseases of the circulatory system (I00-I99) Feed
Other pulmonary heart diseases.
Not applicable to ICD-10 codes. Modifiers are used with CPT and HCPCS codes.
Medical necessity for coding I27 would be established by documentation clearly showing the presence of pulmonary heart disease resulting from underlying conditions such as chronic lung disease, sleep disorders, or other specified causes not fitting into more specific I27 subcategories.The clinical information must support the diagnosis and justify the medical necessity of tests and treatments.
The clinical responsibility lies with the physician diagnosing and managing the patient's pulmonary heart disease. This typically involves a thorough history, physical examination, and appropriate diagnostic testing to determine the underlying cause of the condition and to implement appropriate treatment strategies.Cardiologists or pulmonologists might be involved, depending on the specific circumstances.
- Diseases of the circulatory system (I00-I99)
- I27: Other pulmonary heart diseases; I27.0: Primary pulmonary hypertension; I27.2: Other secondary pulmonary hypertension; I27.8: Other specified pulmonary heart diseases
In simple words: This code is used for heart problems caused by lung issues or other reasons that don't fit into other specific categories.Doctors use this code when the heart problem is linked to the lungs but isn't a primary type of lung heart disease.
This ICD-10-CM code encompasses various pulmonary heart diseases not specifically categorized elsewhere.It includes conditions affecting the heart secondary to lung diseases or other factors, excluding those with more specific codes (e.g., primary pulmonary hypertension, secondary pulmonary arterial hypertension).The code's application depends on the clinical context and documentation, necessitating a thorough review of the patient's medical record to ensure accurate coding.
Example 1: A patient with chronic obstructive pulmonary disease (COPD) develops right-sided heart failure due to pulmonary hypertension.Code I27.23 would be more appropriate, but I27 may be used if COPD is not documented sufficiently. , A patient with interstitial lung disease experiences progressive shortness of breath and is found to have pulmonary hypertension.Code I27 could be used, and additional codes to describe the interstitial lung disease will be needed. , A patient with sleep apnea has elevated pulmonary artery pressure and exhibits signs of cor pulmonale. Code I27.81 might be considered; however, if insufficient information to support I27.81, I27 could be used with additional codes for sleep apnea.
Detailed documentation is needed to support the diagnosis of "other pulmonary heart diseases." This includes comprehensive medical history focusing on pulmonary and cardiovascular symptoms, relevant physical examination findings, results of diagnostic tests (e.g., echocardiogram, pulmonary function tests, cardiac catheterization), and clinical findings indicating pulmonary hypertension. The documentation should clearly state the reason why a more specific code is not appropriate.
** This code should be used cautiously, and only when a more specific code from the I27 category is not clinically appropriate given the available documentation.Careful review of the patient's clinical record is paramount to ensure accurate coding and billing practices.Always refer to the latest ICD-10-CM coding manuals and guidelines for the most current information.
- Revenue Code: This will depend on the specific services rendered and the payer. Revenue codes are not directly tied to ICD-10 codes.
- RVU: RVUs are not directly assigned to ICD-10 codes.Reimbursement depends on the associated procedures and the payer's fee schedule.
- Global Days: Not applicable.This is a diagnostic code, not a procedural code.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes. This relates to procedural coding.
- Fee Schedule: Not applicable.ICD-10 codes do not have fee schedules; reimbursement is determined by the related procedures and the payer's fee schedule.
- Specialties:Cardiology, Pulmonology
- Place of Service:Office, Hospital (Inpatient and Outpatient), Ambulatory Surgical Center, other relevant clinical settings