I42.5 Other restrictive cardiomyopathy

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

Applicable to

• Constrictive cardiomyopathy NOS

Applies from I42 Cardiomyopathy

Includes

• myocardiopathy

Excludes2 (not included here)

• ischemic cardiomyopathy (I25.5)
• peripartum cardiomyopathy (O90.3)
• ventricular hypertrophy (I51.7)

Code first

• pre-existing cardiomyopathy complicating pregnancy and puerperium (O99.4)

Risk adjustment (HCC)

• CMS-HCC V28: HCC 227 — Cardiomyopathy/Myocarditis
• CMS-HCC V22: HCC 85 — Congestive Heart Failure
• RxHCC V08: HCC 186 — Heart Failure
• ESRD V24: HCC 85

MS-DRG index

Defines the logic of DRG(s) 314-316 in MDC 05.

Approximate ICD-9-CM (GEMs)

• 425.4 Other primary cardiomyopathies (approximate)

Code annotations containing back-references to I42.5

Back-references to I42

• Code First: I5A Non-ischemic myocardial injury (non-traumatic) ("cardiomyopathy (I42.-)")

Diagnosis Index entries for I42.5

• Cardiomyopathy (familial) (idiopathic) › constrictive NOS
• Cardiomyopathy (familial) (idiopathic) › restrictive NEC

Nearby codes

• I42.0 Dilated cardiomyopathy
• I42.1 Obstructive hypertrophic cardiomyopathy
• I42.2 Other hypertrophic cardiomyopathy
• I42.3 Endomyocardial (eosinophilic) disease
• I42.4 Endocardial fibroelastosis
• I42.5 Other restrictive cardiomyopathy (this code)
• I42.6 Alcoholic cardiomyopathy
• I42.7 Cardiomyopathy due to drug and external agent
• I42.8 Other cardiomyopathies
• I42.9 Cardiomyopathy, unspecified