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

ICD-10 I27.82

Billable / Specific HCC v28: 107 CC

Chronic pulmonary embolism

I27
Block
0
Synonyms
511
LCDs
27
Payer Policies
11
Linked CPTs

About ICD-10-CM I27.82

ICD-10-CM code I27.82 represents Chronic pulmonary embolism. This is a billable/specific code in the Circulatory System chapter (block I27). The 2026 edition of ICD-10-CM I27.82 became effective on October 1, 2025.

Coding Tips for I27.82

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

HCC capture: document with MEAT each year

I27.82 is a CMS-HCC v28 risk-adjustment code (category 107). 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

I27.82 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 I27.82. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • personal history of pulmonary embolism (Z86.711)

Use Additional Code

When coding I27.82, also report these additional codes when applicable.

  • code, if applicable, for associated long-term (current) use of anticoagulants (Z79.01)

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 107
ESRD-HCC
Category 107
RxHCC (Part D)
Category 107

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 Chronic pulmonary embolism. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for I27.82

Local Coverage Determinations (LCDs) from CMS MACs that list I27.82 as a covered diagnosis.

511 LCDs

Showing top 10 of 511 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 I27.82.

27 policies

5 Medicare

Billing and Coding: Cardiac Catheterization and Coronary Angiography
Policy ID: ART-52850
Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing
Policy ID: ART-56423
Billing and Coding: Cardiac Catheterization and Coronary Angiography
Policy ID: ART-56500
Billing and Coding: Computerized Axial Tomography (CT), Thorax
Policy ID: ART-56580
Billing and Coding: Echocardiography
Policy ID: ART-56625

CPT Codes Commonly Billed with I27.82

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

11 linkages
  • 93979 CMS LCD: Billing and Coding: Non-Invasive Abdominal / Visceral Vascular Studies CMS LCD
  • 93975 CMS LCD: Billing and Coding: Non-Invasive Abdominal / Visceral Vascular Studies CMS LCD
  • 93976 CMS LCD: Billing and Coding: Non-Invasive Abdominal / Visceral Vascular Studies CMS LCD
  • 93978 CMS LCD: Billing and Coding: Non-Invasive Abdominal / Visceral Vascular Studies CMS LCD
  • 93980 CMS LCD: Billing and Coding: Non-Invasive Abdominal / Visceral Vascular Studies CMS LCD
  • 93981 CMS LCD: Billing and Coding: Non-Invasive Abdominal / Visceral Vascular Studies CMS LCD
  • 81240 CMS LCD: Billing and Coding: MolDX: Genetic Testing for Hereditary Thrombophilia CMS LCD
  • 81241 CMS LCD: Billing and Coding: MolDX: Genetic Testing for Hereditary Thrombophilia CMS LCD
  • 93990 CMS LCD: Billing and Coding: Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies CMS LCD
  • 93985 CMS LCD: Billing and Coding: Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies CMS LCD

Convert I27.82 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
I27.82 4162 00000

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

ICD-10 I27.82, Billing FAQ

Is ICD-10 code I27.82 billable? +

Yes, I27.82 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 I27.82? +

Type 1 Excludes (never code together with I27.82): personal history of pulmonary embolism (Z86.711)

Does I27.82 affect Medicare Advantage HCC risk adjustment? +

Yes. I27.82 maps to CMS-HCC v28 category 107. Capture this diagnosis annually for accurate Medicare Advantage risk score.

Is I27.82 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 I27.82? +

Procedures frequently paired with I27.82 include: 93979, 93975, 93976, 93978, 93980.

What ICD-9 codes does I27.82 map to? +

Per CMS GEMs, I27.82 maps to ICD-9 codes: 4162. 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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