2026 ICD-10-CM Diagnosis Code I27.9Pulmonary heart disease, unspecified
ICD-10-CM Codes›I00–I99›I26-I28›I27
- Billable — Valid for Submission
- Risk Adjusts — HCC 226
- Chronic Condition
I27.9 is a billable ICD-10-CM diagnosis code for pulmonary heart disease, unspecified. 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. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Pulmonary heart disease.
For Medicare Advantage risk adjustment, I27.9 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
Code Classification
Medicare Risk Adjustment (HCC)Billing
I27.9 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.
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.
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Inclusion Terms
- Chronic cardiopulmonary disease
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Disease, diseased See Also: Syndrome;
cardiopulmonary, chronic I27.9
pulmonary (chronic) I27.9
pulmonary See Also: Disease, lung;
heart I27.9
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Pulmonary Heart Disease
hypertrophy and dilation of the right ventricle of the heart that is caused by pulmonary hypertension. this condition is often associated with pulmonary parenchymal or vascular diseases, such as chronic obstructive pulmonary disease and pulmonary embolism.
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 I27.9 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About I27.9Overview
What is the ICD-10 code for pulmonary heart disease, unspecified?
The ICD-10-CM code for pulmonary heart disease, unspecified is I27.9 (sometimes written as I279). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
Is I27.9 (Other pulmonary heart diseases) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report pulmonary heart disease, unspecified on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does I27.9 group to?
When pulmonary heart disease, unspecified 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.
What is the ICD-9 equivalent of I27.9?
Under the General Equivalence Mappings, pulmonary heart disease, unspecified converts to ICD-9-CM 416.9 (chr pulmon heart dis NOS). The mapping is approximate, so confirm the match fits the documentation.
What HCC is I27.9?
I27.9 (pulmonary heart disease, unspecified) 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 I27.9 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, I27.9 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.
