I5A vs S26
I5A and S26 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
The official note, declared on I5A
injury of heart (S26.-)
I5A
Non-ischemic myocardial injury (non-traumatic)
Billable
- Chapter 9
- Diseases of the circulatory system
- Section
- I30-I5A
Use when the record says
- Acute (non-ischemic) myocardial injury
- Chronic (non-ischemic) myocardial injury
- Unspecified (non-ischemic) myocardial injury
Indexed under
- Neurogenic stunned myocardium
- Stunned myocardium, neurogenic
- Injury › myocardial
- Injury › heart › non-traumatic
S26
Injury of heart
Not billable
- Chapter 19
- Injury, poisoning and certain other consequences of external causes
- Section
- S20-S29
These two codes sit in different chapters of the Tabular List, which is usually the clearest signal that they describe different underlying processes rather than different degrees of the same one.
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027