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

ICD-10 I27.24

Billable / Specific HCC v28: 85

Chronic thromboembolic pulmonary hypertension

I27
Block
1
Synonyms
448
LCDs
24
Payer Policies
0
Linked CPTs

About ICD-10-CM I27.24

ICD-10-CM code I27.24 represents Chronic thromboembolic pulmonary hypertension. This is a billable/specific code in the Circulatory System chapter (block I27). The 2026 edition of ICD-10-CM I27.24 became effective on October 1, 2025.

Coding Tips for I27.24

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

HCC capture: document with MEAT each year

I27.24 is a CMS-HCC v28 risk-adjustment code (category 85). 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.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under I27.24. Per CMS ICD-10-CM Tabular 2026.

  • Group 4 pulmonary hypertension

Coding Notes

Code Also

  • associated pulmonary embolism, if applicable (I26.-, I27.82)

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 85
ESRD-HCC
Category 85
RxHCC (Part D)
Category 85

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

Medicare LCD Coverage for I27.24

Local Coverage Determinations (LCDs) from CMS MACs that list I27.24 as a covered diagnosis.

448 LCDs

Showing top 10 of 448 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94660 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94726 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94664 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94618 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94772 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94642 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT G0238 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94004 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94668 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94680 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing I27.24.

24 policies

1 Cigna

Anesthesia Services for Interventional Pain Management Procedures in an Adult - (0551)
Policy ID: MM_0551

5 Medicare

Nebulizers - Policy Article
Policy ID: ART-52466
Billing and Coding: Cardiac Catheterization and Coronary Angiography
Policy ID: ART-52850
Billing and Coding: Bariatric Surgery Coverage
Policy ID: ART-53026
Billing and Coding: Bariatric Surgery for Treatment of Co-Morbidities Conditions Related to Morbid Obesity
Policy ID: ART-54923
Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing
Policy ID: ART-56423

CPT Codes Commonly Billed with I27.24

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

No procedure linkages on file for I27.24

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.

ICD-10 I27.24, Billing FAQ

Is ICD-10 code I27.24 billable? +

Yes, I27.24 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to I27.24? +

ICD-10 I27.24 includes: Group 4 pulmonary hypertension.

Does I27.24 affect Medicare Advantage HCC risk adjustment? +

Yes. I27.24 maps to CMS-HCC v28 category 85. Capture this diagnosis annually for accurate Medicare Advantage risk score.

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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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