I26.02 Saddle embolus of pulmonary artery with acute cor pulmonale

Billable ICD-10-CM code, FY2026. Acts as a Major Complication or Comorbidity (MCC) as a secondary diagnosis.

Applies from I26 Pulmonary embolism

Includes

• pulmonary (acute) (artery)(vein) infarction
• pulmonary (acute) (artery)(vein) thromboembolism
• pulmonary (acute) (artery)(vein) thrombosis

Excludes1 (never code together)

• cor pulmonale without embolism (I27.81)

Excludes2 (not included here)

• 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)

Risk adjustment (HCC)

• CMS-HCC V22: HCC 107 — Vascular Disease with Complications
• RxHCC V08: HCC 215 — Venous Thromboembolism
• ESRD V24: HCC 107

MS-DRG index

Defines the logic of DRG(s) 173 in MDC 04.

Approximate ICD-9-CM (GEMs)

• 415.0 Acute cor pulmonale (approximate)
• 415.13 Saddle embolus of pulmonary artery (approximate)

Code annotations containing back-references to I26.02

Back-references to I26.0

• Type 1 Excludes: I27.81 Cor pulmonale (chronic) ("acute cor pulmonale (I26.0-)")

Back-references to I26

• Code Also: I27.24 Chronic thromboembolic pulmonary hypertension ("associated pulmonary embolism, if applicable (I26.-, I27.82)")
• Code First: I5A Non-ischemic myocardial injury (non-traumatic) ("pulmonary embolism (I26.-)")
• Type 2 Excludes: I74 Arterial embolism and thrombosis ("pulmonary embolism and thrombosis (I26.-)")
• Type 2 Excludes: I82 Other venous embolism and thrombosis ("pulmonary (I26.-)")
• Code First: U09.9 Post COVID-19 condition, unspecified ("pulmonary embolism (I26.-)")

Diagnosis Index entries for I26.02

• Embolism (multiple) (paradoxical) › pulmonary (acute) (artery) (vein) › saddle › with acute cor pulmonale
• Embolism (multiple) (paradoxical) › saddle › pulmonary artery › with acute cor pulmonale
• Saddle › embolus › pulmonary artery › with acute cor pulmonale

Nearby codes

• I26 Pulmonary embolism
• I26.0 Pulmonary embolism with acute cor pulmonale
• I26.01 Septic pulmonary embolism with acute cor pulmonale
• I26.02 Saddle embolus of pulmonary artery with acute cor pulmonale (this code)
• I26.03 Cement embolism of pulmonary artery with acute cor pulmonale
• I26.04 Fat embolism of pulmonary artery with acute cor pulmonale
• I26.09 Other pulmonary embolism with acute cor pulmonale
• I26.9 Pulmonary embolism without acute cor pulmonale
• I26.90 Septic pulmonary embolism without acute cor pulmonale