I26
Non-Billable

Pulmonary embolism

Non-Billable / Non-Specific Code

What is Pulmonary embolism?

ICD-10-CM I26 is the diagnosis code for Pulmonary embolism. This code falls under the section "Pulmonary heart disease and diseases of pulmonary circulation" within Chapter 9 — Diseases of the circulatory system (I00-I99). It is a non-billable/non-specific ICD-10-CM code that should not be used for reimbursement. A more specific sub-code is required for billing. Medical coders and healthcare providers use this code to document and classify diagnoses in electronic health records, insurance claims, and clinical databases.

⛔ Excludes1
â„šī¸ Excludes2

Coding Guidelines for I26

⛔ Type 1 Excludes (Never code together)

The following conditions should never be coded at the same time as I26. They are mutually exclusive:

  • cor pulmonale without embolism (I27.81)

â„šī¸ Type 2 Excludes (Code separately if applicable)

The following conditions are not included in I26. If the patient has both, code each condition separately:

  • 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)

ICD-10-CM Code Hierarchy

Understanding where I26 sits in the ICD-10-CM classification helps ensure proper coding:

Sub-Codes 2 entries
I26.0Pulmonary embolism with acute cor pulmonaleNon-BillableI26.01Septic pulmonary embolism with acute cor pulmonaleBillableI26.02Saddle embolus of pulmonary artery with acute cor pulmonaleBillableI26.03Cement embolism of pulmonary artery with acute cor pulmonaleBillableI26.04Fat embolism of pulmonary artery with acute cor pulmonaleBillableI26.09Other pulmonary embolism with acute cor pulmonaleBillableI26.9Pulmonary embolism without acute cor pulmonaleNon-BillableI26.90Septic pulmonary embolism without acute cor pulmonaleBillableI26.92Saddle embolus of pulmonary artery without acute cor pulmonaleBillableI26.93Single subsegmental thrombotic pulmonary embolism without acute cor pulmonaleBillableI26.94Multiple subsegmental thrombotic pulmonary emboli without acute cor pulmonaleBillableI26.95Cement embolism of pulmonary artery without acute cor pulmonaleBillableI26.96Fat embolism of pulmonary artery without acute cor pulmonaleBillableI26.99Other pulmonary embolism without acute cor pulmonaleBillable
Related Codes

Frequently Asked Questions

Is I26 a billable ICD-10-CM code?

No, I26 is a non-billable/non-specific code. You should use a more specific sub-code for billing and reimbursement.

What does I26 mean?

I26 is the ICD-10-CM diagnosis code for "Pulmonary embolism". It is used by healthcare providers to classify and document this condition in medical records and insurance claims.

What section is I26 in?

I26 is located in Section I26-I28 — "Pulmonary heart disease and diseases of pulmonary circulation" within Chapter 9 of the ICD-10-CM Tabular List.

What are the sub-codes of I26?

I26 has 2 sub-code(s) that provide more specific detail: I26.0, I26.9.

When should I use I26?

Use I26 when the patients documented diagnosis matches "Pulmonary embolism" and the clinical documentation supports this level of specificity. Always verify with the latest ICD-10-CM guidelines and payer requirements.

People Also Ask

What is the ICD-10 code for Pulmonary embolism?

The ICD-10-CM code for Pulmonary embolism is I26.

Can I26 be used for primary diagnosis?

No, I26 is non-billable. Use a more specific sub-code for primary diagnosis billing.

What chapter is I26 in?

I26 is in Chapter 9 of the ICD-10-CM Tabular List.

What conditions are excluded from I26?

Type 1 Excludes for I26 include: cor pulmonale without embolism (I27.81).

Is I26 valid for 2026?

Yes, I26 is a valid ICD-10-CM code for the 2026 fiscal year, subject to official CMS updates.

See Also

← PreviousI25.9Chronic ischemic heart disease, unspecifiedNext →I26.0Pulmonary embolism with acute cor pulmonale
Code Details
I26
Pulmonary embolism
Non-Billable / Non-Specific Code
9 — Diseases of the circulatory system (I00-I99)
I26-I28 — Pulmonary heart disease and diseases of pulmonary circulation
2026 ICD-10-CM