ICD-10 Coding for Bilateral Pulmonary Embolism(I26.01, I26.94)
Complete ICD-10-CM coding and documentation guide for Bilateral Pulmonary Embolism. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Bilateral Pulmonary Embolism
I26.0-I26.9Primary Range
Pulmonary embolism and infarction
This range includes codes for various types of pulmonary embolism, including those with and without acute cor pulmonale.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I26.01 | Septic pulmonary embolism with acute cor pulmonale | Use when septic embolism is confirmed with acute cor pulmonale. |
|
| I26.94 | Bilateral subsegmental pulmonary embolism without acute cor pulmonale | Use when imaging confirms bilateral subsegmental embolism without cor pulmonale. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for bilateral pulmonary embolism
Essential facts and insights about Bilateral Pulmonary Embolism
Primary ICD-10-CM Codes for bilateral pulmonary embolism
Decision Criteria
clinical Criteria
- Presence of septic embolism with acute cor pulmonale
Applicable To
- Septic embolism with acute cor pulmonale
Excludes
- Chronic pulmonary embolism (I27.82)
Clinical Validation Requirements
- Microorganism identification
- Echocardiogram showing RV strain
Code-Specific Risks
- Misidentifying septic embolism without cor pulmonale
Coding Notes
- Ensure documentation specifies both septic embolism and acute cor pulmonale.
I26.94 - Bilateral subsegmental pulmonary embolism without acute cor pulmonale
Use when imaging confirms bilateral subsegmental embolism without cor pulmonale.
Applicable To
- Bilateral subsegmental embolism
Excludes
- Pulmonary embolism with acute cor pulmonale (I26.01)
Clinical Validation Requirements
- Imaging showing bilateral subsegmental filling defects
Coding Notes
Ensure documentation specifies 'bilateral' and 'subsegmental'.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Bilateral Pulmonary Embolism to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I26.01.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with coding standards., Financial: Potential loss of reimbursement.
Mitigation Strategy
Always check for cor pulmonale in imaging and labs., Include specific terms in documentation.
Impact
Reimbursement: Incorrect coding can lead to reduced reimbursement., Compliance: May result in non-compliance with coding guidelines., Data Quality: Affects the accuracy of clinical data.
Mitigation Strategy
Use I26.94 for bilateral subsegmental or I26.09 for bilateral lobar PE with cor pulmonale.
Impact
Coding without specifying laterality can lead to audits.
Mitigation Strategy
Ensure documentation always includes laterality.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Bilateral Pulmonary Embolism, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Bilateral Pulmonary Embolism
Use these documentation templates to ensure complete and accurate documentation for Bilateral Pulmonary Embolism. These templates include all required elements for proper coding and billing.
Emergency Department Note
Specialty: Emergency MedicineRequired Elements
- HPI
- Imaging
- Echo
- Labs
- Assessment
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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