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I27.9 ICD-10-CM Code: Pulmonary heart disease, unspecified

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

Coding at a Glance

Tabular directives
1 inclusion term
Risk adjustment
CMS-HCC V28: 1 category · CMS-HCC V22 category 85 · RxHCC V08 category 184

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 v44, 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 184

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 I27.9 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Chronic cardiopulmonary disease

Coder workflow for I27.9

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

Before you code I27.9

  1. Unspecified does not mean incorrect. When the record gives no greater specificity, I27.9 may be the appropriate code. Check the record for detail that supports a more specific sibling. An unspecified code is for records that do not provide the detail a more specific code needs; a query, not an assumption, is the route to specificity (Guidelines I.A.9.b, I.B.18).

    ReviewI27.0, I27.1, I27.2, I27.8

    See the relationships section · Guide: Other vs unspecified (NEC vs NOS) →

Choose the right path

  1. Does the record document the detail a more specific sibling code needs?
    Yes → Review the specific siblings in this subcategory.
    No → Continue — I27.9 is appropriate when the documentation goes no further.

    ReviewI27.0, I27.1, I27.2, I27.8

Consider I27.9. Then confirm the code is valid for the date of service in the Verify section.

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).
Any detail beyond this code’s title
What the record states that a more specific sibling code would capture — or its absence, which itself supports the unspecified code.

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: The provider documents the condition in the terms of this code’s title and records no further detail.

Coding question: Is a more specific sibling code supportable?

Path: Review the specific siblings in this subcategory and what each requires the record to state.

Reason: A more specific code needs documentation of the distinguishing element; without it the unspecified code is appropriate, and a provider query is the route to specificity (Guidelines I.A.9.b, I.B.18).

ReviewI27.0, I27.1, I27.2, I27.8

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

Pulmonary heart disease, unspecified is a billable ICD-10-CM diagnosis code (I27.9).

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 (3)

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

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 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.

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), I27.83 — Eisenmenger's syndrome, I27.89 — Other specified pulmonary heart diseases, 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, I50.32 — Chronic diastolic (congestive) heart failure, I50.40 — Unspecified combined systolic (congestive) and 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, I27.83 — Eisenmenger's syndrome, 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, 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

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.

Prothrombin Time Test and INR (PT/INR)

Contextual Map

Every relationship of I27.9 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.

Hierarchy

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. 15,708 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027

Index entries

  • Disease, diseased, cardiopulmonary, chronic[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Disease, diseased, heart (organic), pulmonary (chronic)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Disease, diseased, pulmonary, heart[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (20)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

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 FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2027), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 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 — v44 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. "I27.9 — Pulmonary heart disease, unspecified." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/i27.9-pulmonary-heart-disease-unspecified

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Pulmonary heart disease, unspecified

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to I27.9 in its code family, with their registry titles.

View all codes in the I27 family