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

ICD-10 I27.29

Billable / Specific HCC v28: 85

Other secondary pulmonary hypertension

I27
Block
5
Synonyms
470
LCDs
31
Payer Policies
3
Linked CPTs

About ICD-10-CM I27.29

ICD-10-CM code I27.29 represents Other secondary pulmonary hypertension. This is a billable/specific code in the Circulatory System chapter (block I27). The 2026 edition of ICD-10-CM I27.29 became effective on October 1, 2025.

Coding Tips for I27.29

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

HCC capture: document with MEAT each year

I27.29 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 I27.29. Per CMS ICD-10-CM Tabular 2026.

  • Group 5 pulmonary hypertension
  • Pulmonary hypertension with unclear multifactorial mechanisms
  • Pulmonary hypertension due to hematologic disorders
  • Pulmonary hypertension due to metabolic disorders
  • Pulmonary hypertension due to other systemic disorders

Coding Notes

Code Also

  • other associated disorders, if known, such as:
  • chronic myeloid leukemia (C92.10-C92.22)
  • essential thrombocythemia (D47.3)
  • Gaucher disease (E75.22)
  • hypertensive chronic kidney disease with end stage renal disease (I12.0, I13.11, I13.2)
  • hyperthyroidism (E05.-)
  • hypothyroidism (E00-E03)
  • polycythemia vera (D45)
  • sarcoidosis (D86.-)

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 I27.29

Local Coverage Determinations (LCDs) from CMS MACs that list I27.29 as a covered diagnosis.

470 LCDs

Showing top 10 of 470 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 I27.29.

31 policies

1 Aetna

Color-Flow Doppler Echocardiography and Myocardial Strain Imaging - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0008

2 Cigna

Anesthesia Services for Interventional Pain Management Procedures in an Adult - (0551)
Policy ID: MM_0551
Plasma Brain Natriuretic Peptide in the Outpatient Setting - (0028)
Policy ID: MM_0028

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: Bariatric Surgical Management of Morbid Obesity
Policy ID: ART-56422

CPT Codes Commonly Billed with I27.29

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

3 linkages
  • 94618 CMS LCD: Billing and Coding: Pulmonary Stress Testing CMS LCD
  • 94619 CMS LCD: Billing and Coding: Pulmonary Stress Testing CMS LCD
  • 94617 CMS LCD: Billing and Coding: Pulmonary Stress Testing CMS LCD

ICD-10 I27.29, Billing FAQ

Is ICD-10 code I27.29 billable? +

Yes, I27.29 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 I27.29? +

ICD-10 I27.29 includes: Group 5 pulmonary hypertension; Pulmonary hypertension with unclear multifactorial mechanisms; Pulmonary hypertension due to hematologic disorders, and 2 more clinical synonyms.

Does I27.29 affect Medicare Advantage HCC risk adjustment? +

Yes. I27.29 maps to CMS-HCC v28 category 85. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What CPT codes are commonly billed with I27.29? +

Procedures frequently paired with I27.29 include: 94618, 94619, 94617.

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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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