ICDcodes.org
FY2027

I26.01Septic pulmonary embolism with acute cor pulmonale

BillableMCC

Is I26.01 billable?

Yes — I26.01 is billable for FY2027. I26.01 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. I26.01 may be submitted for encounters from October 1, 2026 through September 30, 2027.

I26.01 at a glance

CodeI26.01
DescriptionSeptic pulmonary embolism with acute cor pulmonale
BillableYes
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027

What Medicare edits apply to I26.01?

The Medicare Code Editor screens inpatient claims before they are grouped. These edits name I26.01 directly.

Cannot be a principal diagnosis — MCE edit 9

CMS will reject this code as the principal diagnosis on an inpatient claim. It describes something other than the condition chiefly responsible for the admission.

Which MS-DRGs does I26.01 group to?

I26.01 sits in MDC 04 and helps define the logic of 1 MS-DRG (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.

  • 173Ultrasound Accelerated and Other Thrombolysis with Principal Diagnosis Pulmonary Embolismsurgical

As a secondary diagnosis, I26.01 is a major complication or comorbidity (MCC), which can move a stay into a higher-paying DRG.

How is I26.01 listed in the Alphabetic Index?

These are the routes through the Alphabetic Index that lead to I26.01. They show the wording a clinician may have documented, which often differs from the Tabular description.

  • Embolismpulmonarysepticwith acute cor pulmonale (multiple) (paradoxical)

Code first

The underlying condition below must be sequenced before I26.01. I26.01 describes a manifestation and cannot be the principal or first-listed diagnosis.

  • underlying infection

Excludes1 — never code together — inherited from I26

The conditions below can never be reported together with I26.01 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

  • cor pulmonale without embolism (I27.81)

Excludes2 — not included here — inherited from Chapter 9

The conditions below are not part of I26.01, but a patient may have both at the same time. When documentation supports it, I26.01 and the excluded code may both be reported.

  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
  • systemic connective tissue disorders (M30-M36)
  • transient cerebral ischemic attacks and related syndromes (G45.-)

Excludes2 — not included here — inherited from I26

The conditions below are not part of I26.01, but a patient may have both at the same time. When documentation supports it, I26.01 and the excluded code may both be reported.

  • chronic pulmonary embolism (I27.82)
  • personal history of pulmonary embolism (Z86.711)
  • pulmonary embolism complicating abortion, ectopic or molar pregnancy (O00-O07, O08.2)
  • pulmonary embolism complicating pregnancy, childbirth and the puerperium (O88.-)
  • pulmonary embolism due to trauma (T79.0, T79.1)
  • pulmonary embolism due to complications of surgical and medical care (T80.0, T81.7-, T82.8-)
  • septic (non-pulmonary) arterial embolism (I76)

How long has I26.01 existed?

I26.01 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.

Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.

What other codes are in the I26.0 family? (4)