I26.04

Clinical notes

Documentation support

General coding-documentation guidance — not a substitute for payer-specific requirements or professional coding judgment.

• •This code represents a manifestation. Documentation should identify the underlying condition, which must be coded first.
• •As a general rule, code to the highest level of specificity supported by the documentation in the medical record.

Associated MS-DRGs

I26.04 can serve as the principal diagnosis for these Medicare Severity Diagnosis-Related Groups.

Informational only — actual DRG assignment also depends on procedures, complications/comorbidities (CC/MCC), discharge status, and payer-specific rules not reflected here.

• DRG 157Dental and Oral Diseases with MCC
• DRG 158Dental and Oral Diseases with CC
• DRG 159Dental and Oral Diseases without CC/MCC
• DRG 173Ultrasound Accelerated and Other Thrombolysis with Principal Diagnosis Pulmonary Embolism