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

ICD-10 I28.8

Billable / Specific HCC v28: 85

Other diseases of pulmonary vessels

I28
Block
5
Synonyms
224
LCDs
10
Payer Policies
4
Linked CPTs

About ICD-10-CM I28.8

ICD-10-CM code I28.8 represents Other diseases of pulmonary vessels. This is a billable/specific code in the Circulatory System chapter (block I28). The 2026 edition of ICD-10-CM I28.8 became effective on October 1, 2025.

Coding Tips for I28.8

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

HCC capture: document with MEAT each year

I28.8 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 I28.8. Per CMS ICD-10-CM Tabular 2026.

  • Pulmonary arteritis
  • Pulmonary endarteritis
  • Rupture of pulmonary vessels
  • Stenosis of pulmonary vessels
  • Stricture of pulmonary vessels

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 I28.8

Local Coverage Determinations (LCDs) from CMS MACs that list I28.8 as a covered diagnosis.

224 LCDs

Showing top 10 of 224 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 I28.8.

10 policies

5 Medicare

Billing and Coding: Cardiac Catheterization and Coronary Angiography
Policy ID: ART-52850
Billing and Coding: Endovenous Stenting
Policy ID: ART-56414
Billing and Coding: Cardiac Catheterization and Coronary Angiography
Policy ID: ART-56500
Billing and Coding: Echocardiography
Policy ID: ART-56625
Billing and Coding: Endovenous Stenting
Policy ID: ART-56644

1 Aetna

Magnetic Resonance Imaging of the Cardiovascular System - Cardiac MRI
Policy ID: CPB-0520

CPT Codes Commonly Billed with I28.8

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

4 linkages
  • 37238 CMS LCD: Billing and Coding: Endovenous Stenting CMS LCD
  • 37239 CMS LCD: Billing and Coding: Endovenous Stenting CMS LCD
  • 37183 CMS LCD: Billing and Coding: Endovenous Stenting CMS LCD
  • 37182 CMS LCD: Billing and Coding: Endovenous Stenting CMS LCD

Convert I28.8 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
I28.8 4178 00000

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

ICD-10 I28.8, Billing FAQ

Is ICD-10 code I28.8 billable? +

Yes, I28.8 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 I28.8? +

ICD-10 I28.8 includes: Pulmonary arteritis; Pulmonary endarteritis; Rupture of pulmonary vessels, and 2 more clinical synonyms.

Does I28.8 affect Medicare Advantage HCC risk adjustment? +

Yes. I28.8 maps to CMS-HCC v28 category 85. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What CPT codes are commonly billed with I28.8? +

Procedures frequently paired with I28.8 include: 37238, 37239, 37183, 37182.

What ICD-9 codes does I28.8 map to? +

Per CMS GEMs, I28.8 maps to ICD-9 codes: 4178. 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 June 1, 2026.

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