I26.92

Saddle embolus of pulmonary artery without acute cor pulmonale

FY2027Chapter 9: Diseases of the circulatory system/I26–I28 Pulmonary heart disease and diseases of pulmonary circulation

BillableComplete code, valid to report

I26.92 (also written I2692) is a billable ICD-10-CM diagnosis code for saddle embolus of pulmonary artery without acute cor pulmonale. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 12 codes in category I26 (Pulmonary embolism). The Alphabetic Index lists it under 3 entries. Its coding notes include 1 Excludes1 entry and 17 Excludes2 entries.

Excludes1

Not coded here. The listed conditions generally should not be reported together.

Inherited from I26 Pulmonary embolism
  • cor pulmonale without embolism (I27.81)

Excludes2

Not included here. Both codes may be reported if the patient has both conditions.

Inherited from I26 Pulmonary embolism
  • chronic pulmonary embolism (I27.82)
  • personal history of pulmonary embolism (Z86.711)
  • pulmonary embolism complicating abortion, ectopic or molar pregnancy (O00-O07, O08.2)
  • pulmonary embolism complicating pregnancy, childbirth and the puerperium (O88.-)
  • pulmonary embolism due to trauma (T79.0, T79.1)
  • pulmonary embolism due to complications of surgical and medical care (T80.0, T81.7-, T82.8-)
  • septic (non-pulmonary) arterial embolism (I76)
Also from chapter/block level (10 notes)
Inherited from Chapter 9 Diseases of the circulatory system
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
  • systemic connective tissue disorders (M30-M36)
  • transient cerebral ischemic attacks and related syndromes (G45.-)

Care settings

How CMS programs treat this code. These are CMS claim edits and list entries, not coverage or eligibility rules.

Home Health Primary

Accepted as the primary (principal) diagnosis on a home health claim. The Home Health Grouper assigns it to the MMTA - Cardiac and Circulatory clinical group.

Source: CMS Home Health Grouper Software v07.2.26, effective October 1, 2026

Hospital MCC

Counts as a major complication or comorbidity (MCC) when reported as a secondary diagnosis on an inpatient claim. It does not count when the principal diagnosis is one of the 20 codes in its exclusion list. Some MS-DRGs also ignore a CC or MCC that defines the DRG.

Source: CMS MS-DRG Definitions Manual v44, effective October 1, 2026, Appendix C

HAC

On the CMS list of hospital-acquired conditions (HAC 10: Deep Vein Thrombosis (DVT) / Pulmonary Embolism (PE) with Total Knee or Hip Replacement). When the claim reports it with a present-on-admission (POA) indicator of N (not present) or U (documentation insufficient), CMS does not pay the CC or MCC DRG for it. A POA of Y (present) or W (clinically undetermined) is paid normally. Some HAC categories also require a listed procedure.

Source: CMS MS-DRG Definitions Manual v44, effective October 1, 2026, Appendix I; CMS Hospital-Acquired Conditions (HAC) Coding page, POA indicator payment table

Includes

Further defines or gives examples of the content of the category.

Inherited from I26 Pulmonary embolism
  • pulmonary (acute) (artery)(vein) infarction
  • pulmonary (acute) (artery)(vein) thromboembolism
  • pulmonary (acute) (artery)(vein) thrombosis

Alphabetic Index terms

Terms the official Alphabetic Index lists for this code. 3 entries