I28.0
BillableArteriovenous fistula of pulmonary vessels
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
An abnormal connection between an artery and vein in the lungs, causing blood to bypass normal circulation.
Coding Tips
- •Specify whether the fistula is congenital or acquired in the medical record
- •May require additional codes if the fistula is causing hemodynamic complications
Clinical Significance
Arteriovenous fistula of pulmonary vessels is an abnormal connection between pulmonary arteries and veins that causes blood to bypass the gas exchange areas of the lungs. This can result in hypoxemia and paradoxical embolism. It may be congenital (as in hereditary hemorrhagic telangiectasia) or acquired, and often requires interventional treatment.
Documentation Requirements
- ✓Provider diagnosis of pulmonary arteriovenous fistula
- ✓Specification of congenital versus acquired etiology
- ✓Imaging confirmation (CT angiography, conventional angiography)
- ✓Clinical symptoms (dyspnea, cyanosis, clubbing, hemoptysis)
- ✓Assessment for hereditary hemorrhagic telangiectasia if congenital
Excludes 1 — Do NOT code together
- congenital arteriovenous fistula (Q25.72)
Commonly Confused Codes
Q25.72 — Congenital pulmonary arteriovenous malformation; use for congenital cases identified as malformationsI28.1 — Aneurysm of pulmonary artery; different vascular pathology, not a fistulaI28.8 — Other diseases of pulmonary vessels; broader category for unclassified pulmonary vascular conditionsI77.0 — Arteriovenous fistula, acquired; for fistulas in non-pulmonary vessels
Code Hierarchy
└I28Other diseases of pulmonary vessels└I28.0Arteriovenous fistula of pulmonary vessels
└I28.0Arteriovenous fistula of pulmonary vessels