2026 ICD-10-CM Diagnosis Code S26.92XALaceration of heart, unspecified with or without hemopericardium, initial encounter
ICD-10-CM Codes›S00–T88›S20-S29›S26
- Billable — Valid for Submission
- MCC — Major Complication or Comorbidity
- 7th Character A — Initial Encounter
- Not Chronic
S26.92XA is a billable ICD-10-CM diagnosis code for laceration of heart, unspecified with or without hemopericardium, initial encounter. The 7th character A marks it as an initial encounter code, used while the patient is receiving active treatment. 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, 963 through 965. As a secondary diagnosis, it counts as a major complication or comorbidity (MCC) and places an inpatient stay in the highest severity level of its MS-DRG family. It does not count, however, when the principal diagnosis is one of 107 closely related codes. Coders also document this condition as heart injury, open. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Internal organ injury, initial encounter.
Code Identity
Code Classification
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Heart injury, open
- Heart laceration with open wound into thorax, with penetration of heart chambers
- Laceration of heart
- Laceration of heart with penetration of heart chambers
Coding GuidelinesGuidance
The appropriate 7th character is to be added to each code from block Injury of heart (S26). Use the following options for the applicable episode of care:
- A - initial encounter
- D - subsequent encounter
- S - sequela
Source: ICD-10-CM Official Guidelines for Coding and Reporting, FY 2026, published by CMS and the National Center for Health Statistics.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Chest Injuries and Disorders
The chest is the part of your body between your neck and your abdomen (belly). The medical term for your chest is thorax.
The full article covers:
- What is the chest?
- What are chest injuries and disorders?
- How are chest injuries and disorders diagnosed?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert S26.92XA to ICD-9-CMHistory
Code HistoryHistory
Questions About S26.92XAOverview
Is S26.92XA a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report laceration of heart, unspecified with or without hemopericardium, initial encounter on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character A in S26.92XA mean?
The final character A marks the initial encounter: use it while the patient is receiving active treatment for laceration of heart, unspecified with or without hemopericardium, such as an emergency visit or first evaluation.
What MS-DRG does S26.92XA group to?
When laceration of heart, unspecified with or without hemopericardium, initial encounter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 314, 315, 316, 963, 964, 965, with relative weights from 0.6821 to 2.7338 depending on complications. Higher weights mean higher Medicare reimbursement.
Is S26.92XA a CC or MCC?
CMS lists S26.92XA as an MCC (major complication or comorbidity) for FY 2026. Reported as a secondary diagnosis, it places the inpatient stay in the highest-weighted DRG of its severity family. It does not count when the principal diagnosis is one of the 107 closely related codes in its exclusion list.
What is the ICD-9 equivalent of S26.92XA?
Under the General Equivalence Mappings, laceration of heart, unspecified with or without hemopericardium, initial encounter converts to ICD-9-CM 861.02 (heart laceration-closed) and 861.03 (heart chamber lacerat-cl). The mapping is approximate, so confirm the match fits the documentation.
