ICD-10 I26
Non-Billable HeaderPulmonary embolism
About ICD-10-CM I26
ICD-10-CM code I26 represents Pulmonary embolism. This is a non-billable header code in the Circulatory System chapter (block I26). The 2026 edition of ICD-10-CM I26 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Type 1 Excludes
Pure excludes, these codes can never be coded together with I26. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- cor pulmonale without embolism (I27.81)
Type 2 Excludes
Not included here, the excluded code is not part of I26, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.
- 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
- pulmonary (acute) (artery)(vein) infarction
- pulmonary (acute) (artery)(vein) thromboembolism
- pulmonary (acute) (artery)(vein) thrombosis
Medicare LCD Coverage for I26
Local Coverage Determinations (LCDs) from CMS MACs that list I26 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing I26.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but I26 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with I26
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To I26
Other codes in section I26-I28 (Pulmonary heart disease and diseases of pulmonary circulation).
ICD-10 I26, Billing FAQ
Is ICD-10 code I26 billable? +
No, I26 is a non-billable header code. Use a more specific child code from block I26 when submitting claims.
What codes are Type 1 Excludes for I26? +
Type 1 Excludes (never code together with I26): cor pulmonale without embolism (I27.81)
What codes are Type 2 Excludes for I26? +
Type 2 Excludes (may be coded together when both conditions exist): chronic pulmonary embolism (I27.82); personal history of pulmonary embolism (Z86.711); pulmonary embolism complicating abortion, ectopic or molar pregnancy (O00-O07, O08.2)
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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