I26.01

Billable

Septic pulmonary embolism with acute cor pulmonale

HCC Category Mapping

V28HCC 267 — Vascular Disease

0.356

What This Code Means

A life-threatening emergency where an infected blood clot travels to the lungs and causes the right side of the heart to fail acutely.

Coding Tips

•This code requires documentation of both sepsis/infection and acute cor pulmonale; verify both conditions are present
•This is a high-acuity code; ensure appropriate emergency department or ICU level of care documentation

Clinical Significance

Septic pulmonary embolism with acute cor pulmonale represents infected embolic material (typically from endocarditis or infected venous catheter sites) lodging in the pulmonary vasculature and causing acute right heart failure. This is a life-threatening condition requiring both antimicrobial therapy and hemodynamic support. The presence of acute cor pulmonale indicates significant right ventricular strain from the embolic burden and is associated with higher mortality.

Documentation Requirements

✓Evidence of pulmonary embolism on imaging (CT pulmonary angiography, ventilation-perfusion scan)
✓Documentation that the embolic material is septic/infectious in nature — source identification (endocarditis, infected line, septic thrombophlebitis)
✓Evidence of acute cor pulmonale — right heart dilation, right ventricular dysfunction on echocardiography, elevated right heart pressures, or clinical signs
✓Microbiological data including blood cultures and sensitivity results
✓Combined antimicrobial and hemodynamic treatment plan

Code First

underlying infection

Commonly Confused Codes

I26.90 — Septic pulmonary embolism without acute cor pulmonale; same embolic type but without right heart failure I26.09 — Other pulmonary embolism with acute cor pulmonale; non-septic embolism with cor pulmonale I26.02 — Saddle embolus with acute cor pulmonale; specific anatomic location, not septic origin I33.0 — Acute endocarditis; source of septic emboli, may be coded additionally

Code Hierarchy

└I26Pulmonary embolism └I26.0Pulmonary embolism with acute cor pulmonale └I26.01Septic pulmonary embolism with acute cor pulmonale

└I26.01Septic pulmonary embolism with acute cor pulmonale