2026 ICD-10-CM Diagnosis Code I27.1Kyphoscoliotic heart disease

ICD-10-CM Codes›I00–I99›I26-I28›I27

ICD-10-CM I27.1
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

I27.1 is a billable ICD-10-CM diagnosis code for kyphoscoliotic heart disease. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 314 through 316. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 13 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Pulmonary heart disease.

For Medicare Advantage risk adjustment, I27.1 maps to CMS-HCC Category 226 (Heart Failure, Except End Stage and Acute) under the V28 model, adding a risk factor of about 0.360 for a community, non-dual, aged beneficiary in payment year 2026.

Code Identity

ICD-10-CM Code
I27.1
Billable Status
Yes — Valid for Submission
Code Describes
Kyphoscoliotic heart disease
Short Description
Kyphoscoliotic heart disease
Same as the full description in the CMS dataset.
Parent Code
Other pulmonary heart diseases

Code Classification

ChapterI00–I99Diseases of the circulatory system
SectionI26-I28Pulmonary heart disease and diseases of pulmonary circulation
CategoryI27Other pulmonary heart diseases
This CodeI27.1Kyphoscoliotic heart disease

Medicare Risk Adjustment (HCC)Billing

I27.1 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2026.

CMS-HCC V28 Category (Payment Model)
HCC 226— Heart Failure, Except End Stage and Acute
Payment HCC · PY 2026 one of 34 ICD-10-CM codes in this category
Risk Adjustment Factor (RAF) Weight
+0.360
community, non-dual, aged · ranges 0.217–0.537 across segments
Hierarchy
Superseded by HCC 221, HCC 222, HCC 223, HCC 224, and HCC 225
a more severe related category takes the payment when both are reported
Prior Model (CMS-HCC V24)
HCC 85
V24 retired V28 pays 100% of MA risk scores since PY 2026
Other CMS Models
PACE (CMS-HCC V22): HCC 85 · ESRD (V21): HCC 85 · ESRD (V24): HCC 85
ESRD V21 weights: 0.082 dialysis, 0.186–0.336 functioning graft · ESRD V24 weights: 0.063 dialysis, 0.169–0.302 functioning graft
Part D (RxHCC)
RxHCC 184 — Pulmonary Hypertension, Except Arterial, and Other Pulmonary Heart Disease
also risk-adjusts in the Part D prescription drug model (V08)

Source: CMS Payment Year 2026 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Kyphoscoliotic heart disease
  • Right ventricular failure due to pulmonary disease

Index to Diseases and InjuriesGuidance

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR CIR014
Pulmonary heart disease
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Heart Diseases

Heart disease is a general term that includes many types of heart problems. It's a type of cardiovascular disease, which means heart and blood vessel disease.

The full article covers:

  • What is heart disease?
  • What are the types of heart disease?
  • What causes heart diseases?
  • Who is more likely to develop heart diseases?
  • What are the symptoms of heart disease?
  • How are heart diseases diagnosed?
  • What are the treatments for heart disease?
  • Can heart diseases be prevented?

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert I27.1 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
416.1 Kyphoscoliotic heart dis
Exact Match The mapping is direct, with no qualifiers.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About I27.1Overview

What is the ICD-10 code for kyphoscoliotic heart disease?

The ICD-10-CM code for kyphoscoliotic heart disease is I27.1 (sometimes written as I271). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

Is I27.1 (Other pulmonary heart diseases) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report kyphoscoliotic heart disease on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does I27.1 group to?

When kyphoscoliotic heart disease is the principal diagnosis on an inpatient stay, it groups to MS-DRG 314, 315, 316, with relative weights from 0.6821 to 2.0852 depending on complications. Higher weights mean higher Medicare reimbursement.

Is I27.1 a CC or MCC?

CMS lists I27.1 as a CC (complication or comorbidity) for FY 2026. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 13 closely related codes in its exclusion list.

What is the ICD-9 equivalent of I27.1?

Under the General Equivalence Mappings, kyphoscoliotic heart disease converts to ICD-9-CM 416.1 (kyphoscoliotic heart dis). The mapping is a direct match.

What HCC is I27.1?

I27.1 (kyphoscoliotic heart disease) maps to CMS-HCC Category 226 (Heart Failure, Except End Stage and Acute), commonly written as HCC 226, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2026. It mapped to HCC 85 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. In the Part D prescription drug model it maps to RxHCC 184.

Does I27.1 risk-adjust for Medicare Advantage payment?

Yes. When documented and reported on a Medicare Advantage encounter, I27.1 adds a risk adjustment factor of about 0.360 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.217 to 0.537 depending on the payment segment). A more severe related category (HCC 221, HCC 222, HCC 223, HCC 224, and HCC 225) supersedes it when both are reported. See the full factor table on the HCC 226 category page.