I26
Header — not billablePulmonary embolism
The ICD-10 code for pulmonary embolism is I26.
I26 is a non-billable header code. It groups related conditions but cannot be used on its own for reimbursement — select one of the 2 more specific codes below.
Clinical notes
Excludes1 (not coded here)
An Excludes1 note is a pure exclusion: the excluded condition and this code should never be reported together, because the two conditions cannot occur at the same time (e.g. a congenital form vs. an acquired form of the same disease).
- cor pulmonale without embolism (I27.81)
Excludes2 (not included here)
An Excludes2 note means the excluded condition is not part of this one, but a patient can have both at the same time — in that case both codes may be reported together.
- 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)
Includes
Terms listed here further define or give examples of the conditions grouped under this code — they describe what the code covers, not a separate diagnosis.
- pulmonary (acute) (artery)(vein) infarction
- pulmonary (acute) (artery)(vein) thromboembolism
- pulmonary (acute) (artery)(vein) thrombosis
Documentation support
General coding-documentation guidance — not a substitute for payer-specific requirements or professional coding judgment.
- •This is a non-billable header code. Documentation must support a more specific child code before this diagnosis can be reported on a claim.
- •Confirm the excluded condition(s) listed above are not also present — Excludes1 conditions cannot be coded together with this one.
- •As a general rule, code to the highest level of specificity supported by the documentation in the medical record.
Related codes in this category
- I27Other pulmonary heart diseasesnon-billable header
- I28Other diseases of pulmonary vesselsnon-billable header
- I26Pulmonary embolismnon-billable header