I42.8
BillableOther cardiomyopathies
HCC Category Mapping
V28HCC 227 — Cardiomyopathy
0.339V24HCC 85 — Congestive Heart Failure
0.368ESRDHCC 85 — Congestive Heart Failure
0.000RxHCCHCC 186 — Heart Failure
0.000What This Code Means
Heart muscle disease that does not fit into the standard categories of dilated, hypertrophic, or restrictive cardiomyopathy.
Coding Tips
- •Use this code only after excluding other specific cardiomyopathy types; document the clinical presentation and any unique features
- •Review the medical record for any additional diagnostic findings that might allow for a more specific cardiomyopathy classification
Clinical Significance
This code captures cardiomyopathies that do not fit standard classifications (dilated, hypertrophic, restrictive, alcoholic, or drug-induced). Examples include Takotsubo (stress) cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, and noncompaction cardiomyopathy. These conditions have unique management requirements and prognostic implications.
Documentation Requirements
- ✓Provider diagnosis of a specific cardiomyopathy type not classified elsewhere
- ✓Description of the specific cardiomyopathy variant
- ✓Diagnostic evidence (echocardiogram, cardiac MRI, biopsy)
- ✓Clinical presentation and functional status
- ✓Treatment plan specific to the cardiomyopathy type
Commonly Confused Codes
I42.0 — Dilated cardiomyopathy; use when dilation is the primary featureI42.9 — Cardiomyopathy, unspecified; use when the type is truly undeterminedI51.81 — Takotsubo syndrome; now has its own specific code in recent ICD-10 updatesI42.5 — Other restrictive cardiomyopathy; use when restriction is the dominant physiology