ICD-10 Coding for Saddle Pulmonary Embolism(I26.02, I26.92)
Complete ICD-10-CM coding and documentation guide for Saddle Pulmonary Embolism. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Saddle Pulmonary Embolism
I26.0-I26.9Primary Range
Pulmonary embolism and infarction
This range includes codes for acute pulmonary embolism, including saddle pulmonary embolism with or without acute cor pulmonale.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I26.02 | Saddle embolus of pulmonary artery with acute cor pulmonale | Use when imaging confirms a saddle embolus and there is evidence of acute cor pulmonale. |
|
| I26.92 | Saddle embolus of pulmonary artery without acute cor pulmonale | Use when imaging confirms a saddle embolus but there is no evidence of acute cor pulmonale. |
|
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 saddle pulmonary embolism
Essential facts and insights about Saddle Pulmonary Embolism
Primary ICD-10-CM Codes for saddle pulmonary embolism
Decision Criteria
clinical Criteria
- Presence of acute right heart strain or failure
documentation Criteria
- CT angiography confirming saddle embolus
Applicable To
- Saddle embolus with acute right heart strain
Excludes
- Chronic pulmonary embolism (I27.82)
Clinical Validation Requirements
- CT pulmonary angiography showing saddle embolus
- Echocardiogram indicating RV dilation or hypokinesis
- Elevated troponin levels
Code-Specific Risks
- Misidentifying acute cor pulmonale
- Omitting necessary imaging documentation
Coding Notes
- Ensure documentation specifies 'saddle embolus' and confirms acute cor pulmonale.
I26.92 - Saddle embolus of pulmonary artery without acute cor pulmonale
Use when imaging confirms a saddle embolus but there is no evidence of acute cor pulmonale.
Applicable To
- Saddle embolus without right heart dysfunction
Excludes
- Chronic pulmonary embolism (I27.82)
Clinical Validation Requirements
- CT pulmonary angiography showing saddle embolus
- Normal cardiac biomarkers
Coding Notes
Documentation must specify the absence of acute cor pulmonale.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential 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 Saddle Pulmonary Embolism to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I26.02.
Impact
Clinical: Misrepresentation of patient's clinical status., Regulatory: Potential audit issues., Financial: Incorrect DRG assignment affecting reimbursement.
Mitigation Strategy
Ensure thorough review of echocardiogram results, Document cardiac status explicitly
Impact
Reimbursement: Incorrect DRG assignment leading to reimbursement errors., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Always use I26.02 or I26.92 for saddle PE.
Impact
Failure to document acute cor pulmonale can lead to incorrect coding.
Mitigation Strategy
Implement mandatory documentation checks for cardiac status.
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 Saddle Pulmonary Embolism, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Saddle Pulmonary Embolism
Use these documentation templates to ensure complete and accurate documentation for Saddle Pulmonary Embolism. These templates include all required elements for proper coding and billing.
Acute presentation of saddle PE
Specialty: PulmonologyRequired Elements
- Imaging findings
- Cardiac status
- Provoking factors
- Anticoagulation therapy
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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