ICD-10 Coding for Pulmonary Thrombosis(I26.99, I27.82)
Complete ICD-10-CM coding and documentation guide for Pulmonary Thrombosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Pulmonary Thrombosis
I26-I28Primary Range
Pulmonary heart disease
This range includes codes for acute and chronic pulmonary embolism and other pulmonary heart diseases.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I26.99 | Other pulmonary embolism without acute cor pulmonale | Use for acute pulmonary embolism without cor pulmonale when confirmed by imaging and clinical symptoms. |
|
| I27.82 | Chronic pulmonary embolism | Use for chronic pulmonary embolism when the patient is stable and on long-term anticoagulation. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for pulmonary thrombosis
Essential facts and insights about Pulmonary Thrombosis
Primary ICD-10-CM Codes for pulmonary thrombosis
Decision Criteria
clinical Criteria
- Presence of acute symptoms and imaging confirmation
Applicable To
- Acute pulmonary embolism without cor pulmonale
Excludes
- Chronic pulmonary embolism (I27.82)
Clinical Validation Requirements
- Sudden onset of dyspnea
- Elevated troponin levels
- RV strain on echocardiogram
- Positive findings on CTA
Code-Specific Risks
- Misclassification as chronic if not properly documented
Coding Notes
- Ensure documentation specifies 'acute' to avoid defaulting to chronic codes.
I27.82 - Chronic pulmonary embolism
Use for chronic pulmonary embolism when the patient is stable and on long-term anticoagulation.
Applicable To
- Chronic thromboembolic pulmonary hypertension
Excludes
- Acute pulmonary embolism (I26.99)
Clinical Validation Requirements
- Asymptomatic status
- Long-term anticoagulation therapy
- No acute symptoms present
Coding Notes
Document chronicity and treatment duration clearly.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Long term (current) use of anticoagulants
Z79.01Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Pulmonary Thrombosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I26.99.
Impact
Clinical: Inaccurate clinical records affecting treatment decisions., Regulatory: Non-compliance with ICD-10 coding standards., Financial: Potential denial of claims due to unspecified coding.
Mitigation Strategy
Always include laterality in documentation., Use templates that prompt for laterality.
Impact
Reimbursement: Incorrect DRG assignment leading to reimbursement issues., Compliance: Potential non-compliance with coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Verify and document the chronicity and treatment plan.
Impact
Coding PE without specifying acuity or laterality increases audit risk.
Mitigation Strategy
Implement documentation templates that require acuity and laterality.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Pulmonary Thrombosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Pulmonary Thrombosis
Use these documentation templates to ensure complete and accurate documentation for Pulmonary Thrombosis. These templates include all required elements for proper coding and billing.
Acute Pulmonary Embolism Diagnosis
Specialty: PulmonologyRequired Elements
- Acuity
- Location
- Provoked status
- Imaging results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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