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Alphabetic Index and Tabular path
HCC Buddy public API, FY2026 Apr updateSource load source requiredSource year 2026Updated 2026-04-01

Index trail

Cardiomyopathy in diseases classified elsewhere

See Tabular List: I43

I43, Cardiomyopathy in diseases classified elsewhere

Selected code, source checked for the selected effective period

Commonly confused codes

official source

Not listed for this effective period.

Code details and official notes

I43

Cardiomyopathy in diseases classified elsewhere

Open the shareable code page for I43→
billableHCC mapped

Includes

official source

Not listed for this effective period.

Excludes 1

official source
  • cardiomyopathy (in):
  • coxsackie (virus) (B33.24)
  • diphtheria (A36.81)
  • sarcoidosis (D86.85)
  • tuberculosis (A18.84)

Excludes 2

official source

No Excludes 2 note is listed in this source payload.

Code First

official source
  • underlying disease, such as:
  • amyloidosis (E85.-)
  • glycogen storage disease (E74.0-)
  • gout (M10.0-)
  • thyrotoxicosis (E05.0-E05.9-)

Use Additional

official source

Not listed for this effective period.

Code Also

official source

Not listed for this effective period.

7th character

official source

Not listed for this code in the selected Tabular payload.

Placeholder X

official source

Not listed for this code in the selected Tabular payload.

Laterality

official source

No laterality instruction is listed for this code in the selected Tabular payload.

Effective period

source required
  • FY2026 Apr update
  • Source year 2026
  • Updated 2026-04-01
  • HCC Buddy public API
HCC Buddy
HCC Buddy
Alphabetic Index and Tabular path
HCC Buddy public API, FY2026 Apr updateSource load source requiredSource year 2026Updated 2026-04-01

Index trail

Cardiomyopathy in diseases classified elsewhere

See Tabular List: I43

I43, Cardiomyopathy in diseases classified elsewhere

Selected code, source checked for the selected effective period

Commonly confused codes

official source

Not listed for this effective period.

Code details and official notes

I43

Cardiomyopathy in diseases classified elsewhere

Open the shareable code page for I43→
billableHCC mapped

Includes

official source

Not listed for this effective period.

Excludes 1

official source
  • cardiomyopathy (in):
  • coxsackie (virus) (B33.24)
  • diphtheria (A36.81)
  • sarcoidosis (D86.85)
  • tuberculosis (A18.84)

Excludes 2

official source

No Excludes 2 note is listed in this source payload.

Code First

official source
  • underlying disease, such as:
  • amyloidosis (E85.-)
  • glycogen storage disease (E74.0-)
  • gout (M10.0-)
  • thyrotoxicosis (E05.0-E05.9-)

Use Additional

official source

Not listed for this effective period.

Code Also

official source

Not listed for this effective period.

7th character

official source

Not listed for this code in the selected Tabular payload.

Placeholder X

official source

Not listed for this code in the selected Tabular payload.

Laterality

official source

No laterality instruction is listed for this code in the selected Tabular payload.

Effective period

source required
  • FY2026 Apr update
  • Source year 2026
  • Updated 2026-04-01
  • HCC Buddy public API
HCC Buddy Insights

HCC Mapping

HCC 227 Cardiomyopathy/Myocarditis (V28)HCC 85 Congestive Heart Failure (V24)HCC 186 Heart Failure (RxHCC)HCC 85 Congestive Heart Failure (ESRD/PACE)HCC 130 HHS-HCC 130; HHS-HCC 2026 benefit year (HHS-HCC)

RAF Value

V28: RAF: 0.189V24: RAF: 0.331RxHCC: RAF: 0.110ESRD/PACE: RAF: 0.063HHS-HCC: RAF: Varies by metal level

Model Period

FY2026 Apr update

Source

source required

Audit Caution

Close codes need documentation support before selection. Do not assume relationships.
Reviewed by the HCC Buddy Coding Team

HCC Buddy workflow band

HCC mapping, RAF, MEAT, source trail, and audit caution stay in view.

MEAT supportaudit cautionsource required

V28

HCC 227

Cardiomyopathy/Myocarditis

RAF: 0.189

V24

HCC 85

Congestive Heart Failure

RAF: 0.331

RxHCC

RxHCC 186

Heart Failure

RAF: 0.110

ESRD/PACE

HCC 85

Congestive Heart Failure

RAF: 0.063

HHS-HCC

HCC 130

HHS-HCC 130; HHS-HCC 2026 benefit year

RAF: Varies by metal level

MEAT checklist

Reviewed by the HCC Buddy Coding Team

Monitor, Evaluate, Assess, or Treat must be supported in the provider note.

HCC Buddy guidance, not official ICD-10-CM text.

Audit caution

Reviewed by the HCC Buddy Coding Team

Close codes need documentation support before selection. Do not assume relationships.

HCC Buddy guidance, not official ICD-10-CM text.

Reviewer sign-off

Reviewed by the HCC Buddy Coding Team

MEAT, documentation support, audit cautions, and close-code guidance are reviewed and approved for this effective period.

HCC Buddy enrichment is separate from official source text.

Last updated: April 1, 2026 · Not a substitute for official coding guidelines. No PHI or patient data.
HCC Buddy Code Card
FY 2026 Apr update
I43Billable

Cardiomyopathy in diseases classified elsewhere

CMS-HCC V28

HCC 227

RAF 0.189

CMS-HCC V24

HCC 85

RAF 0.331

RxHCC

RxHCC 186

RAF 0.110

Reviewed by the HCC Buddy Coding TeamFY2026 Apr update

Code

I43

V28 HCC

HCC 227

RAF

0.189

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