I27.81
BillableCor pulmonale (chronic)
HCC Category Mapping
V28HCC 226 — Heart Failure, Specified
0.000V24HCC 85 — Congestive Heart Failure
0.368ESRDHCC 85 — Congestive Heart Failure
0.000RxHCCHCC 184 — Pulmonary Hypertension, Other
0.000What This Code Means
Chronic heart disease of the right side of the heart caused by long-standing lung disease or pulmonary hypertension.
Coding Tips
- •Code the underlying pulmonary condition (such as COPD or pulmonary hypertension) separately
- •This represents the structural and functional changes of the right heart in response to chronic lung disease
Clinical Significance
Chronic cor pulmonale represents right ventricular enlargement and failure secondary to chronic lung disease or pulmonary hypertension. It indicates advanced cardiopulmonary disease with significant mortality risk and high resource utilization. This diagnosis reflects the downstream cardiac consequences of chronic pulmonary disease.
Documentation Requirements
- ✓Provider diagnosis of chronic cor pulmonale
- ✓Evidence of right ventricular hypertrophy or dilation (echocardiogram, cardiac MRI)
- ✓Underlying chronic lung disease or pulmonary hypertension documented
- ✓Symptoms of right heart failure (peripheral edema, jugular venous distention, hepatomegaly)
- ✓Distinction from acute cor pulmonale clearly documented
Excludes 1 — Do NOT code together
- acute cor pulmonale (I26.0-)
Code Also
- , if applicable, right heart failure (I50.81-)
Commonly Confused Codes
I26.09 — Other pulmonary embolism with acute cor pulmonale; this is acute, not chronicI27.0 — Primary pulmonary hypertension; a cause of cor pulmonale, not the same entityI50.810 — Right heart failure, unspecified; less specific than cor pulmonaleI27.23 — Pulmonary hypertension due to lung diseases; the hypertension preceding cor pulmonale
Code Hierarchy
└I27Other pulmonary heart diseases└I27.8Other specified pulmonary heart diseases└I27.81Cor pulmonale (chronic)
└I27.81Cor pulmonale (chronic)