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I27.83 ICD-10-CM Code: Eisenmenger's syndrome

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
3 inclusion terms · 5 code-also instructions
Risk adjustment
CMS-HCC V28: 1 category · CMS-HCC V22 category 85 · RxHCC V08 category 183

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.

  • MS-DRG 314 — OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC (MDC 05)
  • MS-DRG 315 — OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC (MDC 05)
  • MS-DRG 316 — OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC (MDC 05)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 226 — Heart Failure, Except End-Stage and Acute (supersedes HCC 227)

Other models: CMS-HCC V22 HCC 85 · RxHCC V08 HCC 183

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for I27.83 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Eisenmenger's complex
  • (Irreversible) Eisenmenger's disease
  • Pulmonary hypertension with right to left shunt related to congenital heart disease

Code Also

Additional codes that may be required to fully describe the encounter.

  • underlying heart defect, if known, such as:
  • atrial septal defect (Q21.1-)
  • Eisenmenger's defect (Q21.8)
  • patent ductus arteriosus (Q25.0)
  • ventricular septal defect (Q21.0)

Coder workflow for I27.83

MedCoder structured workflow — derived from this code’s own official record

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
Acuity
Acute or chronic as documented; when both are documented and separate codes exist, both are reported with the acute code first (Guidelines I.B.8).

Official instructions as workflow

  • Code Also — related condition(5 notes)

    Coding workflow: Review the related condition when both are documented and the instruction applies. A Code Also note does not fix sequencing; the order follows the circumstances of the encounter.

    ReviewQ21.1, Q21.8, Q25.0, Q21.0

    See the official tabular notes · Guidelines I.A.17

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Code Overview

Eisenmenger's syndrome is a billable ICD-10-CM diagnosis code (I27.83).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Indexed Clinical Terms (5)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Official Coding Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Verbatim excerpts from the ICD-10-CM Official Guidelines for Coding and Reporting (CMS/NCHS) that govern this code.

Chapter 9: Diseases of the Circulatory System (I00 -I99)

11) Pulmonary Hypertension Pulmonary hypertension is classified to category I27, Other pulmonary heart diseases. For secondary pulmonary hypertension (I27.1, I27.2-), code also any associated conditions or adverse effects of drugs or toxins. The sequencing is based on the reason for the encounter, except for adverse effects of drugs (See Section I.C.19.e.).

Verify Before Coding

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name I27.83 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Excludes1 note: I27.2 — Other secondary pulmonary hypertension.

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 1 Code Also instruction: Q21.8 — Other congenital malformations of cardiac septa.

These codes suggest coding this condition alongside when both are present.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 3 MS-DRGs: DRG 314 (MDC 05), DRG 315 (MDC 05), DRG 316 (MDC 05).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):CIR014 — Pulmonary heart disease (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Heart Failure, Except End-Stage and Acute) for risk-adjusted payment.

I13.2 — Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease, I27.0 — Primary pulmonary hypertension, I27.1 — Kyphoscoliotic heart disease, I27.20 — Pulmonary hypertension, unspecified, I27.21 — Secondary pulmonary arterial hypertension, I27.22 — Pulmonary hypertension due to left heart disease, I27.23 — Pulmonary hypertension due to lung diseases and hypoxia, I27.24 — Chronic thromboembolic pulmonary hypertension, I27.29 — Other secondary pulmonary hypertension, I27.81 — Cor pulmonale (chronic), I27.89 — Other specified pulmonary heart diseases, I27.9 — Pulmonary heart disease, unspecified, I28.0 — Arteriovenous fistula of pulmonary vessels, I28.1 — Aneurysm of pulmonary artery, I28.8 — Other diseases of pulmonary vessels, I28.9 — Disease of pulmonary vessels, unspecified, I50.1 — Left ventricular failure, unspecified, I50.20 — Unspecified systolic (congestive) heart failure, I50.22 — Chronic systolic (congestive) heart failure, I50.30 — Unspecified diastolic (congestive) heart failure, +13 more

Related risk categories

These categories interact through CMS's HCC hierarchy — one can suppress the other's risk-adjustment weight when both are present on a claim.

Heart Failure with Heart Assist Device/Artificial Heart, Acute on Chronic Heart Failure, Acute Heart Failure (Excludes Acute on Chronic), Cardiomyopathy/Myocarditis

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Pulmonary heart disease).

I27.1 — Kyphoscoliotic heart disease, I27.2 — Other secondary pulmonary hypertension, I27.20 — Pulmonary hypertension, unspecified, I27.21 — Secondary pulmonary arterial hypertension, I27.22 — Pulmonary hypertension due to left heart disease, I27.23 — Pulmonary hypertension due to lung diseases and hypoxia, I27.24 — Chronic thromboembolic pulmonary hypertension, I27.29 — Other secondary pulmonary hypertension, I27.81 — Cor pulmonale (chronic), I27.82 — Chronic pulmonary embolism, I27.840 — Fontan-associated liver disease [FALD], I27.841 — Fontan-associated lymphatic dysfunction, I27.848 — Other Fontan-associated condition, I27.849 — Fontan related circulation, unspecified, I27.89 — Other specified pulmonary heart diseases, I27.9 — Pulmonary heart disease, unspecified, I28.0 — Arteriovenous fistula of pulmonary vessels, I28.1 — Aneurysm of pulmonary artery, I28.8 — Other diseases of pulmonary vessels, I28.9 — Disease of pulmonary vessels, unspecified, +1 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “Hypertension, hypertensive”, “Complex”; these codes share that main term but sit in a different category of the Tabular List.

I15.0 — Renovascular hypertension (renovascular), I15.1 — Hypertension secondary to other renal disorders (due to, renal disorders NEC), I15.2 — Hypertension secondary to endocrine disorders (due to, pheochromocytoma), I15.8 — Other secondary hypertension (secondary NEC, specified NEC), I15.9 — Secondary hypertension, unspecified (secondary NEC), I16.0 — Hypertensive urgency (urgency), I16.1 — Hypertensive emergency (emergency), I16.9 — Hypertensive crisis, unspecified (crisis), I1A.0 — Resistant hypertension (resistant), I26.09 — Other pulmonary embolism with acute cor pulmonale (pulmonary, with, cor pulmonale, acute), I67.4 — Hypertensive encephalopathy (encephalopathy), I70.1 — Atherosclerosis of renal artery (Goldblatt's), I87.30 — Chronic venous hypertension (idiopathic) without complications (venous, idiopathic, asymptomatic), I87.309 — Chronic venous hypertension (idiopathic) without complications of unspecified lower extremity (venous, idiopathic), I87.31 — Chronic venous hypertension (idiopathic) with ulcer (venous, idiopathic, with, ulcer), I87.32 — Chronic venous hypertension (idiopathic) with inflammation (venous, idiopathic, with, inflammation), I87.33 — Chronic venous hypertension (idiopathic) with ulcer and inflammation (venous, idiopathic, with, inflammation, with ulcer), I87.39 — Chronic venous hypertension (idiopathic) with other complications (venous, idiopathic, with, specified complication NEC), I97.3 — Postprocedural hypertension (postoperative), K31.89 — Other diseases of stomach and duodenum (portal, gastropathy), +63 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Gamma-glutamyl Transferase (GGT) Test, Iron Panel, Partial Thromboplastin Time (PTT) Test, Prothrombin Time Test and INR (PT/INR)

Contextual Map

Every relationship of I27.83 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run I27.83 with these 5 related codes in Claim Check

Hierarchy

Code Also

Referenced by Excludes1 notes

Referenced by Code Also instructions

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

  • HCC 226 — Heart Failure, Except End-Stage and Acute [CMS-HCC]: “Heart Failure, Except End-Stage and Acute — supersedes HCC 227 (Cardiomyopathy/Myocarditis)”— CMS-HCC V28 · 2026

MS-DRG Grouper

MDC crossing

  • MDC 05 — Diseases and Disorders of the Circulatory System[MDC crossing]: “Diseases and Disorders of the Circulatory System — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 17,209 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

  • Complex, Eisenmenger's (ventricular septal defect)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Disease, diseased, Eisenmenger's (irreversible)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Eisenmenger's, complex or syndrome[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Hypertension, hypertensive (accelerated) (benign) (essential) (idiopathic) (malignant) (systemic), pulmonary, with, right to left shunt related to congenital heart disease[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Syndrome, Eisenmenger's[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (20)

Change history

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2026), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page
Risk adjustment Official source data
2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "I27.83 — Eisenmenger's syndrome." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/i27.83-eisenmengers-syndrome

Change history

  • FY2018 — October 1, 2017
    Added to the code set
    Eisenmenger's syndrome
    FY2018 changes

Nearest Codes in This Family

Official ICD-10-CM classifications closest to I27.83 in its code family, with their registry titles.

View all codes in the I27 family