ICD-10 S26
Non-Billable HeaderInjury of heart
About ICD-10-CM S26
ICD-10-CM code S26 represents Injury of heart. This is a non-billable header code in the Injury, Poisoning, and External Causes chapter (block S26). The 2026 edition of ICD-10-CM S26 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Coding Tips for S26
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
Injury codes require a 7th character: A (initial encounter, active treatment), D (subsequent, healing/recovery), S (sequela, late effect of original injury). Codes with fewer than 6 characters need the placeholder X to bring them to 6 characters before adding the 7th. Wrong or missing 7th character is the #1 cause of injury claim denials.
Coding Notes
Code Also
- any associated:
- open wound of thorax (S21.-)
- traumatic hemopneumothorax (S27.2)
- traumatic hemothorax (S27.1)
- traumatic pneumothorax (S27.0)
Seven Chr Note
- The appropriate 7th character is to be added to each code from category S26
Medicare LCD Coverage for S26
Local Coverage Determinations (LCDs) from CMS MACs that list S26 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing S26.
1 Aetna
2 Cigna
CPT Codes Commonly Billed with S26
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
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.
Codes Adjacent To S26
Other codes in section S20-S29 (Injuries to the thorax).
ICD-10 S26, Billing FAQ
Is ICD-10 code S26 billable? +
No, S26 is a non-billable header code. Use a more specific child code from block S26 when submitting claims.
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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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