ICD-10 code for pulmonary embolism

The ICD-10-CM code for pulmonary embolism is I26.99 (Other pulmonary embolism without acute cor pulmonale). The official index lists 11 more specific codes, so check the documentation for details such as type, cause, site or severity before settling on I26.99.

It is also searched as PE.

Within I26.9, choose I26.99 (Other pulmonary embolism without acute cor pulmonale) only when documentation doesn't support a more specific option: septic pulmonary embolism without acute cor pulmonale (I26.90), saddle embolus of pulmonary artery without acute cor pulmonale (I26.92), single subsegmental thrombotic pulmonary embolism without acute cor pulmonale (I26.93), multiple subsegmental thrombotic pulmonary emboli without acute cor pulmonale (I26.94), cement embolism of pulmonary artery without acute cor pulmonale (I26.95) and fat embolism of pulmonary artery without acute cor pulmonale (I26.96).

As a secondary diagnosis it is an MCC (major complication or comorbidity), which can move an inpatient stay into the highest-paying "with MCC" MS-DRG of its family, unless the principal diagnosis excludes it.

In MS-DRG v44.0, it is part of the grouping logic for DRG 173 (Ultrasound Accelerated and Other Thrombolysis with Principal Diagnosis Pulmonary Embolism, relative weight 2.9556), DRG 175 (Pulmonary Embolism with MCC or Acute Cor Pulmonale, relative weight 1.3652), DRG 176 (Pulmonary Embolism without MCC, relative weight 0.8063), DRG 791 (Prematurity with Major Problems, relative weight 4.1075) and DRG 793 (Full Term Neonate with Major Problems, relative weight 4.2195), in MDC 04 (Diseases and Disorders of the Respiratory System) and MDC 15 (Newborns and Other Neonates with Conditions Originating in the Perinatal Period), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.