ICD-10 I46.8
Billable / Specific HCC v28: 84 MCCCardiac arrest due to other underlying condition
About ICD-10-CM I46.8
ICD-10-CM code I46.8 represents Cardiac arrest due to other underlying condition. This is a billable/specific code in the Circulatory System chapter (block I46). The 2026 edition of ICD-10-CM I46.8 became effective on October 1, 2025.
Coding Tips for I46.8
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
I46.8 is a CMS-HCC v28 risk-adjustment code (category 84). 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.
I46.8 is designated MCC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-MCC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag MCC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Coding Notes
Code First
- underlying condition
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Inpatient DRG Impact, MCC
codes Cardiac arrest due to other underlying condition. As a Major Complication/Comorbidity (MCC), this can shift the DRG assignment to a higher-weighted category, substantial reimbursement impact.
Medicare LCD Coverage for I46.8
Local Coverage Determinations (LCDs) from CMS MACs that list I46.8 as a covered diagnosis.
Showing top 10 of 575 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing I46.8.
5 Medicare
CPT Codes Commonly Billed with I46.8
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 93281 CMS LCD: Billing and Coding: Cardiac Rhythm Device Evaluation CMS LCD
- 93280 CMS LCD: Billing and Coding: Cardiac Rhythm Device Evaluation CMS LCD
- 93296 CMS LCD: Billing and Coding: Cardiac Rhythm Device Evaluation CMS LCD
- 93279 CMS LCD: Billing and Coding: Cardiac Rhythm Device Evaluation CMS LCD
- 93283 CMS LCD: Billing and Coding: Cardiac Rhythm Device Evaluation CMS LCD
- 93261 CMS LCD: Billing and Coding: Cardiac Rhythm Device Evaluation CMS LCD
- 93288 CMS LCD: Billing and Coding: Cardiac Rhythm Device Evaluation CMS LCD
- 93282 CMS LCD: Billing and Coding: Cardiac Rhythm Device Evaluation CMS LCD
- 93724 CMS LCD: Billing and Coding: Cardiac Rhythm Device Evaluation CMS LCD
- 93286 CMS LCD: Billing and Coding: Cardiac Rhythm Device Evaluation CMS LCD
Convert I46.8 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| I46.8 | 4275 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To I46.8
Other codes in section I30-I5A (Other forms of heart disease).
ICD-10 I46.8, Billing FAQ
Is ICD-10 code I46.8 billable? +
Yes, I46.8 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does I46.8 affect Medicare Advantage HCC risk adjustment? +
Yes. I46.8 maps to CMS-HCC v28 category 84. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is I46.8 a CC or MCC for inpatient DRG? +
Yes, this code is designated as MCC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What CPT codes are commonly billed with I46.8? +
Procedures frequently paired with I46.8 include: 93281, 93280, 93296, 93279, 93283.
What ICD-9 codes does I46.8 map to? +
Per CMS GEMs, I46.8 maps to ICD-9 codes: 4275. 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 2, 2026.
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