2025 ICD-10-CM code I26.9
(Active) Effective Date: N/A Diseases of the circulatory system - Pulmonary heart disease and diseases of pulmonary circulation 9 Feed
Pulmonary embolism without acute cor pulmonale.
Medical necessity for this code is established by the confirmed diagnosis of pulmonary embolism without right ventricular dysfunction. Treatment is essential to prevent potentially life-threatening complications.
Diagnosis and management of pulmonary embolism, including assessment of risk factors, diagnostic testing (e.g., CTPA, V/Q scan), anticoagulation therapy, and monitoring for complications.
In simple words: This code refers to a blood clot in the lung's arteries, but without immediate strain on the right side of the heart.
Pulmonary embolism without acute cor pulmonale. This condition involves blockage in one or more arteries in the lungs.It is specifically classified as *without* acute cor pulmonale, meaning there is no sudden right-sided heart strain due to the embolism.
Example 1: A 50-year-old patient presents with sudden onset of shortness of breath and chest pain.A CT pulmonary angiogram (CTPA) confirms the presence of a pulmonary embolism. The patient is started on anticoagulant therapy., A 30-year-old woman postpartum experiences rapid breathing and discomfort in her chest. Diagnostic imaging identifies a pulmonary embolism, and she begins treatment with blood thinners., A 65-year-old patient with a history of deep vein thrombosis develops sudden chest pain and lightheadedness while recovering from recent surgery.Imaging reveals a pulmonary embolism without right heart strain, indicating the absence of acute cor pulmonale. Anticoagulant medication is initiated.
Documentation should include evidence supporting the diagnosis of pulmonary embolism (e.g., imaging findings), details about the patient's symptoms and clinical presentation, absence of acute cor pulmonale, risk factors, and treatment plan.
** Excludes1: cor pulmonale without embolism (I27.81) Excludes2: chronic pulmonary embolism (I27.82) personal history of pulmonary embolism (Z86.711) pulmonary embolism complicating abortion, ectopic or molar pregnancy (O00-O07, O08.2) pulmonary embolism complicating pregnancy, childbirth and the puerperium (O88.-) pulmonary embolism due to trauma (T79.0, T79.1) pulmonary embolism due to complications of surgical and medical care (T80.0, T81.7-, T82.8-) septic (non-pulmonary) arterial embolism (I76)
- Specialties:Pulmonology, Internal Medicine, Cardiology, Emergency Medicine, Critical Care Medicine
- Place of Service:Inpatient Hospital, Emergency Room - Hospital, Office, Outpatient Hospital, Other Place of Service