I42.00 — Dilated cardiomyopathy, unspecified
Is I42.00 billable?
Yes, but I42.00 is an unspecified code. I42.00 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, I42.00 is an unspecified or catch-all code. Payers apply additional scrutiny to unspecified codes and many deny them when the medical record supports a more specific option, so check the documentation before selecting I42.00 — the more specific alternatives are listed below.
More specific alternatives
I42.00 at a glance
| Code | I42.00 |
|---|---|
| Description | Dilated cardiomyopathy, unspecified |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| FY2027 change | New in FY2027 |
Which MS-DRGs does I42.00 group to?
I42.00 sits in MDC 05 and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 314Other Circulatory System Diagnoses with MCCmedical
- 315Other Circulatory System Diagnoses with CCmedical
- 316Other Circulatory System Diagnoses without CC/MCCmedical
As a secondary diagnosis, I42.00 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is I42.00 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to I42.00. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Cardiomyopathy › congestive (familial) (idiopathic)
- Cardiomyopathy › dilated (familial) (idiopathic)
Inclusion terms
Alternative wording in documentation that is classified to I42.00.
- Congestive cardiomyopathy, NOS
Code first — inherited from I42
The underlying condition below must be sequenced before I42.00. I42.00 describes a manifestation and cannot be the principal or first-listed diagnosis.
- pre-existing cardiomyopathy complicating pregnancy and puerperium (O99.4)
Excludes2 — not included here — inherited from Chapter 9
The conditions below are not part of I42.00, but a patient may have both at the same time. When documentation supports it, I42.00 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 I42
The conditions below are not part of I42.00, but a patient may have both at the same time. When documentation supports it, I42.00 and the excluded code may both be reported.