ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 I24.9

Billable / Specific HCC v28: 87 CC

Acute ischemic heart disease, unspecified

I24
Block
0
Synonyms
395
LCDs
23
Payer Policies
51
Linked CPTs

About ICD-10-CM I24.9

ICD-10-CM code I24.9 represents Acute ischemic heart disease, unspecified. This is a billable/specific code in the Circulatory System chapter (block I24). The 2026 edition of ICD-10-CM I24.9 became effective on October 1, 2025.

Coding Tips for I24.9

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

HCC capture: document with MEAT each year

I24.9 is a CMS-HCC v28 risk-adjustment code (category 87). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.

Inpatient DRG impact: CC

I24.9 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

Type 1 Excludes

Pure excludes, these codes can never be coded together with I24.9. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • ischemic heart disease (chronic) NOS (I25.9)

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 87
ESRD-HCC
Category 87
RxHCC (Part D)
Category 87

Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.

Inpatient DRG Impact, CC

codes Acute ischemic heart disease, unspecified. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for I24.9

Local Coverage Determinations (LCDs) from CMS MACs that list I24.9 as a covered diagnosis.

395 LCDs

Showing top 10 of 395 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93313 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93312 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93318 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93317 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT C8927 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT C8925 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93314 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT C8926 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93316 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93315 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing I24.9.

23 policies

2 Aetna

Holter Monitors - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0019
Positron Emission Tomography (PET) - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0071

3 Cigna

Duplex Scan of Extracranial Arteries - (0542)
Policy ID: MM_0542
Plasma Brain Natriuretic Peptide in the Outpatient Setting - (0028)
Policy ID: MM_0028
Transthoracic Echocardiography in Adults - (0510)
Policy ID: MM_0510

5 Medicare

Billing and Coding: Cardiac Catheterization and Coronary Angiography
Policy ID: ART-52850
Billing and Coding: Cardiac Radionuclide Imaging
Policy ID: ART-56476
Billing and Coding: Cardiovascular Nuclear Medicine
Policy ID: ART-56494
Billing and Coding: Cardiac Catheterization and Coronary Angiography
Policy ID: ART-56500
Billing and Coding: Echocardiography
Policy ID: ART-56625

CPT Codes Commonly Billed with I24.9

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

51 linkages
  • 92979 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
  • C9607 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
  • C9600 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
  • 92937 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
  • 92920 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
  • C9608 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
  • 92943 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
  • C9601 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
  • 92941 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
  • 92973 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD

Convert I24.9 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
I24.9 41189 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 I24.9, Billing FAQ

Is ICD-10 code I24.9 billable? +

Yes, I24.9 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What codes are Type 1 Excludes for I24.9? +

Type 1 Excludes (never code together with I24.9): ischemic heart disease (chronic) NOS (I25.9)

Does I24.9 affect Medicare Advantage HCC risk adjustment? +

Yes. I24.9 maps to CMS-HCC v28 category 87. Capture this diagnosis annually for accurate Medicare Advantage risk score.

Is I24.9 a CC or MCC for inpatient DRG? +

Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.

What CPT codes are commonly billed with I24.9? +

Procedures frequently paired with I24.9 include: 92979, C9607, C9600, 92937, 92920.

What ICD-9 codes does I24.9 map to? +

Per CMS GEMs, I24.9 maps to ICD-9 codes: 41189. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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