PCM · Cardiology
PCM Qualifying Diagnoses
for Cardiology.
197 ICD-10-CM codes cover cardiology patients for Principal Care Management (PCM).
Qualifying Codes
ICD-10 codes for cardiology.
Cardiovascular
Essential hypertension
I101 codesrpmccmpcmHome blood pressure readings, typically twice daily, reviewed against a target set in the care plan.
Essential hypertension
I101 codesrpmccmpcmCMS chronic condition · CCW category: Hypertension · Devices: Blood pressure cuff
| Code | Official ICD-10-CM description | Programs | Risk adjustment |
|---|---|---|---|
| I10 | Essential (primary) hypertension | rpmccmpcm | not risk adjusted |
Hypertensive heart and kidney disease
I11, I12, I13, I15, I1616 codesrpmccmpcmBlood pressure plus daily weight, since fluid status drives both the cardiac and the renal picture.
Hypertensive heart and kidney disease
I11, I12, I13, I15, I1616 codesrpmccmpcmCMS chronic condition · CCW category: Hypertension · Devices: Blood pressure cuff, Connected weight scale
I13 codes combine heart and kidney involvement and require the CKD stage to be coded alongside.
| Code | Official ICD-10-CM description | Programs | Risk adjustment |
|---|---|---|---|
| I11.0 | Hypertensive heart disease with heart failure | rpmccmpcm | HCC 226 · Heart Failure, Except End-Stage and Acute |
| I11.9 | Hypertensive heart disease without heart failure | rpmccmpcm | not risk adjusted |
| I12.0 | Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease | rpmccmpcm | HCC 326 · Chronic Kidney Disease, Stage 5 |
| I12.9 | Hypertensive chronic kidney disease with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney diseaselow specificity | rpmccmpcm | not risk adjusted |
| I13.0 | Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease | rpmccmpcm | HCC 226 · Heart Failure, Except End-Stage and Acute |
| I13.10 | Hypertensive heart and chronic kidney disease without heart failure, with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney diseaselow specificity | rpmccmpcm | not risk adjusted |
| I13.11 | Hypertensive heart and chronic kidney disease without heart failure, with stage 5 chronic kidney disease, or end stage renal disease | rpmccmpcm | HCC 326 · Chronic Kidney Disease, Stage 5 |
| I13.2 | Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease | rpmccmpcm | HCC 226 · Heart Failure, Except End-Stage and Acute |
| I15.0 | Renovascular hypertension | rpmccmpcm | not risk adjusted |
| I15.1 | Hypertension secondary to other renal disorders | rpmccmpcm | not risk adjusted |
| I15.2 | Hypertension secondary to endocrine disorders | rpmccmpcm | not risk adjusted |
| I15.8 | Other secondary hypertension | rpmccmpcm | not risk adjusted |
| I15.9 | Secondary hypertension, unspecified | rpmccmpcm | not risk adjusted |
| I16.0 | Hypertensive urgency | rpmccmpcm | not risk adjusted |
| I16.1 | Hypertensive emergency | rpmccmpcm | not risk adjusted |
| I16.9 | Hypertensive crisis, unspecified | rpmccmpcm | not risk adjusted |
Heart failure
I5023 codesrpmccmpcmDaily weight is the primary signal, since a two to three pound overnight gain precedes decompensation. Blood pressure and pulse oximetry support diuretic titration.
Heart failure
I5023 codesrpmccmpcmCMS chronic condition · CCW category: Heart Failure and Non-Ischemic Heart Disease · Devices: Connected weight scale, Blood pressure cuff, Pulse oximeter
Read the heart failure monitoring guide
| Code | Official ICD-10-CM description | Programs | Risk adjustment |
|---|---|---|---|
| I50.1 | Left ventricular failure, unspecified | rpmccmpcm | HCC 226 · Heart Failure, Except End-Stage and Acute |
| I50.20 | Unspecified systolic (congestive) heart failure | rpmccmpcm | HCC 226 · Heart Failure, Except End-Stage and Acute |
| I50.21 | Acute systolic (congestive) heart failure | rpmccmpcm | HCC 225 · Acute Heart Failure (Excludes Acute on Chronic) |
| I50.22 | Chronic systolic (congestive) heart failure | rpmccmpcm | HCC 226 · Heart Failure, Except End-Stage and Acute |
| I50.23 | Acute on chronic systolic (congestive) heart failure | rpmccmpcm | HCC 224 · Acute on Chronic Heart Failure |
| I50.30 | Unspecified diastolic (congestive) heart failure | rpmccmpcm | HCC 226 · Heart Failure, Except End-Stage and Acute |
| I50.31 | Acute diastolic (congestive) heart failure | rpmccmpcm | HCC 225 · Acute Heart Failure (Excludes Acute on Chronic) |
| I50.32 | Chronic diastolic (congestive) heart failure | rpmccmpcm | HCC 226 · Heart Failure, Except End-Stage and Acute |
| I50.33 | Acute on chronic diastolic (congestive) heart failure | rpmccmpcm | HCC 224 · Acute on Chronic Heart Failure |
| I50.40 | Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | rpmccmpcm | HCC 226 · Heart Failure, Except End-Stage and Acute |
| I50.41 | Acute combined systolic (congestive) and diastolic (congestive) heart failure | rpmccmpcm | HCC 225 · Acute Heart Failure (Excludes Acute on Chronic) |
| I50.42 | Chronic combined systolic (congestive) and diastolic (congestive) heart failure | rpmccmpcm | HCC 226 · Heart Failure, Except End-Stage and Acute |
| I50.43 | Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | rpmccmpcm | HCC 224 · Acute on Chronic Heart Failure |
| I50.810 | Right heart failure, unspecified | rpmccmpcm | HCC 226 · Heart Failure, Except End-Stage and Acute |
| I50.811 | Acute right heart failure | rpmccmpcm | HCC 225 · Acute Heart Failure (Excludes Acute on Chronic) |
| I50.812 | Chronic right heart failure | rpmccmpcm | HCC 226 · Heart Failure, Except End-Stage and Acute |
| I50.813 | Acute on chronic right heart failure | rpmccmpcm | HCC 225 · Acute Heart Failure (Excludes Acute on Chronic) |
| I50.814 | Right heart failure due to left heart failure | rpmccmpcm | HCC 226 · Heart Failure, Except End-Stage and Acute |
| I50.82 | Biventricular heart failure | rpmccmpcm | HCC 226 · Heart Failure, Except End-Stage and Acute |
| I50.83 | High output heart failure | rpmccmpcm | HCC 226 · Heart Failure, Except End-Stage and Acute |
| I50.84 | End stage heart failure | rpmccmpcm | HCC 222 · End-Stage Heart Failure |
| I50.89 | Other heart failure | rpmccmpcm | HCC 226 · Heart Failure, Except End-Stage and Acute |
| I50.9 | Heart failure, unspecified | rpmccmpcm | HCC 226 · Heart Failure, Except End-Stage and Acute |
Cardiomyopathy and myocarditis
I42, I43, I40, I41, I51.717 codesrpmccmpcmWeight and blood pressure trending, with rhythm capture where arrhythmia is part of the picture.
Cardiomyopathy and myocarditis
I42, I43, I40, I41, I51.717 codesrpmccmpcmCMS chronic condition · CCW category: Heart Failure and Non-Ischemic Heart Disease · Devices: Connected weight scale, Blood pressure cuff, Single-lead ECG
Effective 2026-10-01: I42.0 splits on 2026-10-01 into I42.00, I42.01 (familial or genetic) and I42.09. Check your problem list before the cutover.
| Code | Official ICD-10-CM description | Programs | Risk adjustment |
|---|---|---|---|
| I40.0 | Infective myocarditis | rpmccmpcm | not risk adjusted |
| I40.1 | Isolated myocarditis | rpmccmpcm | not risk adjusted |
| I40.8 | Other acute myocarditis | rpmccmpcm | not risk adjusted |
| I40.9 | Acute myocarditis, unspecified | rpmccmpcm | not risk adjusted |
| I41 | Myocarditis in diseases classified elsewhere | rpmccmpcm | not risk adjusted |
| I42.0 | Dilated cardiomyopathydeleted 2026-10-01 | rpmccmpcm | HCC 227 · Cardiomyopathy/Myocarditis |
| I42.1 | Obstructive hypertrophic cardiomyopathy | rpmccmpcm | HCC 227 · Cardiomyopathy/Myocarditis |
| I42.2 | Other hypertrophic cardiomyopathy | rpmccmpcm | HCC 227 · Cardiomyopathy/Myocarditis |
| I42.3 | Endomyocardial (eosinophilic) disease | rpmccmpcm | HCC 227 · Cardiomyopathy/Myocarditis |
| I42.4 | Endocardial fibroelastosis | rpmccmpcm | HCC 227 · Cardiomyopathy/Myocarditis |
| I42.5 | Other restrictive cardiomyopathy | rpmccmpcm | HCC 227 · Cardiomyopathy/Myocarditis |
| I42.6 | Alcoholic cardiomyopathy | rpmccmpcm | HCC 227 · Cardiomyopathy/Myocarditis |
| I42.7 | Cardiomyopathy due to drug and external agent | rpmccmpcm | not risk adjusted |
| I42.8 | Other cardiomyopathiesdeleted 2026-10-01 | rpmccmpcm | HCC 227 · Cardiomyopathy/Myocarditis |
| I42.9 | Cardiomyopathy, unspecified | rpmccmpcm | HCC 227 · Cardiomyopathy/Myocarditis |
| I43 | Cardiomyopathy in diseases classified elsewhere | rpmccmpcm | HCC 227 · Cardiomyopathy/Myocarditis |
| I51.7 | Cardiomegaly | rpmccmpcm | not risk adjusted |
Atrial fibrillation and flutter
I489 codesrpmccmpcmRate and rhythm capture plus blood pressure, most often during rate-control or anticoagulation management.
Atrial fibrillation and flutter
I489 codesrpmccmpcmCMS chronic condition · CCW category: Atrial Fibrillation and Flutter · Devices: Single-lead ECG, Blood pressure cuff
I48.1 and I48.2 are no longer valid on their own. Code to I48.11, I48.19, I48.20 or I48.21.
Read the atrial fibrillation and flutter monitoring guide
| Code | Official ICD-10-CM description | Programs | Risk adjustment |
|---|---|---|---|
| I48.0 | Paroxysmal atrial fibrillation | rpmccmpcm | HCC 238 · Specified Heart Arrhythmias |
| I48.11 | Longstanding persistent atrial fibrillation | rpmccmpcm | HCC 238 · Specified Heart Arrhythmias |
| I48.19 | Other persistent atrial fibrillation | rpmccmpcm | HCC 238 · Specified Heart Arrhythmias |
| I48.20 | Chronic atrial fibrillation, unspecified | rpmccmpcm | HCC 238 · Specified Heart Arrhythmias |
| I48.21 | Permanent atrial fibrillation | rpmccmpcm | HCC 238 · Specified Heart Arrhythmias |
| I48.3 | Typical atrial flutter | rpmccmpcm | HCC 238 · Specified Heart Arrhythmias |
| I48.4 | Atypical atrial flutter | rpmccmpcm | HCC 238 · Specified Heart Arrhythmias |
| I48.91 | Unspecified atrial fibrillation | rpmccmpcm | HCC 238 · Specified Heart Arrhythmias |
| I48.92 | Unspecified atrial flutter | rpmccmpcm | HCC 238 · Specified Heart Arrhythmias |
Ischemic heart disease
I20, I24, I2567 codesrpmccmpcmBlood pressure and heart rate against anti-anginal and secondary-prevention targets.
Ischemic heart disease
I20, I24, I2567 codesrpmccmpcmCMS chronic condition · CCW category: Ischemic Heart Disease · Devices: Blood pressure cuff, Single-lead ECG
| Code | Official ICD-10-CM description | Programs | Risk adjustment |
|---|---|---|---|
| I20.0 | Unstable angina | rpmccmpcm | HCC 229 · Unstable Angina and Other Acute Ischemic Heart Disease |
| I20.1 | Angina pectoris with documented spasm | rpmccmpcm | not risk adjusted |
| I20.2 | Refractory angina pectoris | rpmccmpcm | not risk adjusted |
| I20.81 | Angina pectoris with coronary microvascular dysfunction | rpmccmpcm | not risk adjusted |
| I20.89 | Other forms of angina pectoris | rpmccmpcm | not risk adjusted |
| I20.9 | Angina pectoris, unspecifiedlow specificity | rpmccmpcm | not risk adjusted |
| I24.0 | Acute coronary thrombosis not resulting in myocardial infarction | rpmccmpcm | HCC 229 · Unstable Angina and Other Acute Ischemic Heart Disease |
| I24.1 | Dressler's syndrome | rpmccmpcm | HCC 229 · Unstable Angina and Other Acute Ischemic Heart Disease |
| I24.81 | Acute coronary microvascular dysfunction | rpmccmpcm | HCC 229 · Unstable Angina and Other Acute Ischemic Heart Disease |
| I24.89 | Other forms of acute ischemic heart disease | rpmccmpcm | HCC 229 · Unstable Angina and Other Acute Ischemic Heart Disease |
| I24.9 | Acute ischemic heart disease, unspecified | rpmccmpcm | HCC 229 · Unstable Angina and Other Acute Ischemic Heart Disease |
| I25.10 | Atherosclerotic heart disease of native coronary artery without angina pectoris | rpmccmpcm | not risk adjusted |
| I25.110 | Atherosclerotic heart disease of native coronary artery with unstable angina pectoris | rpmccmpcm | HCC 229 · Unstable Angina and Other Acute Ischemic Heart Disease |
| I25.111 | Atherosclerotic heart disease of native coronary artery with angina pectoris with documented spasm | rpmccmpcm | not risk adjusted |
| I25.112 | Atherosclerotic heart disease of native coronary artery with refractory angina pectoris | rpmccmpcm | not risk adjusted |
| I25.118 | Atherosclerotic heart disease of native coronary artery with other forms of angina pectoris | rpmccmpcm | not risk adjusted |
| I25.119 | Atherosclerotic heart disease of native coronary artery with unspecified angina pectorislow specificity | rpmccmpcm | not risk adjusted |
| I25.2 | Old myocardial infarction | rpmccmpcm | not risk adjusted |
| I25.3 | Aneurysm of heart | rpmccmpcm | not risk adjusted |
| I25.41 | Coronary artery aneurysm | rpmccmpcm | not risk adjusted |
| I25.42 | Coronary artery dissection | rpmccmpcm | not risk adjusted |
| I25.5 | Ischemic cardiomyopathy | rpmccmpcm | not risk adjusted |
| I25.6 | Silent myocardial ischemia | rpmccmpcm | not risk adjusted |
| I25.700 | Atherosclerosis of coronary artery bypass graft(s), unspecified, with unstable angina pectoris | rpmccmpcm | HCC 229 · Unstable Angina and Other Acute Ischemic Heart Disease |
| I25.701 | Atherosclerosis of coronary artery bypass graft(s), unspecified, with angina pectoris with documented spasmlow specificity | rpmccmpcm | not risk adjusted |
| I25.702 | Atherosclerosis of coronary artery bypass graft(s), unspecified, with refractory angina pectorislow specificity | rpmccmpcm | not risk adjusted |
| I25.708 | Atherosclerosis of coronary artery bypass graft(s), unspecified, with other forms of angina pectorislow specificity | rpmccmpcm | not risk adjusted |
| I25.709 | Atherosclerosis of coronary artery bypass graft(s), unspecified, with unspecified angina pectorislow specificity | rpmccmpcm | not risk adjusted |
| I25.710 | Atherosclerosis of autologous vein coronary artery bypass graft(s) with unstable angina pectoris | rpmccmpcm | HCC 229 · Unstable Angina and Other Acute Ischemic Heart Disease |
| I25.711 | Atherosclerosis of autologous vein coronary artery bypass graft(s) with angina pectoris with documented spasm | rpmccmpcm | not risk adjusted |
| I25.712 | Atherosclerosis of autologous vein coronary artery bypass graft(s) with refractory angina pectoris | rpmccmpcm | not risk adjusted |
| I25.718 | Atherosclerosis of autologous vein coronary artery bypass graft(s) with other forms of angina pectoris | rpmccmpcm | not risk adjusted |
| I25.719 | Atherosclerosis of autologous vein coronary artery bypass graft(s) with unspecified angina pectorislow specificity | rpmccmpcm | not risk adjusted |
| I25.720 | Atherosclerosis of autologous artery coronary artery bypass graft(s) with unstable angina pectoris | rpmccmpcm | HCC 229 · Unstable Angina and Other Acute Ischemic Heart Disease |
| I25.721 | Atherosclerosis of autologous artery coronary artery bypass graft(s) with angina pectoris with documented spasm | rpmccmpcm | not risk adjusted |
| I25.722 | Atherosclerosis of autologous artery coronary artery bypass graft(s) with refractory angina pectoris | rpmccmpcm | not risk adjusted |
| I25.728 | Atherosclerosis of autologous artery coronary artery bypass graft(s) with other forms of angina pectoris | rpmccmpcm | not risk adjusted |
| I25.729 | Atherosclerosis of autologous artery coronary artery bypass graft(s) with unspecified angina pectorislow specificity | rpmccmpcm | not risk adjusted |
| I25.730 | Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with unstable angina pectoris | rpmccmpcm | HCC 229 · Unstable Angina and Other Acute Ischemic Heart Disease |
| I25.731 | Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with angina pectoris with documented spasm | rpmccmpcm | not risk adjusted |
| I25.732 | Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with refractory angina pectoris | rpmccmpcm | not risk adjusted |
| I25.738 | Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with other forms of angina pectoris | rpmccmpcm | not risk adjusted |
| I25.739 | Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with unspecified angina pectorislow specificity | rpmccmpcm | not risk adjusted |
| I25.750 | Atherosclerosis of native coronary artery of transplanted heart with unstable angina | rpmccmpcm | HCC 229 · Unstable Angina and Other Acute Ischemic Heart Disease |
| I25.751 | Atherosclerosis of native coronary artery of transplanted heart with angina pectoris with documented spasm | rpmccmpcm | not risk adjusted |
| I25.752 | Atherosclerosis of native coronary artery of transplanted heart with refractory angina pectoris | rpmccmpcm | not risk adjusted |
| I25.758 | Atherosclerosis of native coronary artery of transplanted heart with other forms of angina pectoris | rpmccmpcm | not risk adjusted |
| I25.759 | Atherosclerosis of native coronary artery of transplanted heart with unspecified angina pectorislow specificity | rpmccmpcm | not risk adjusted |
| I25.760 | Atherosclerosis of bypass graft of coronary artery of transplanted heart with unstable angina | rpmccmpcm | HCC 229 · Unstable Angina and Other Acute Ischemic Heart Disease |
| I25.761 | Atherosclerosis of bypass graft of coronary artery of transplanted heart with angina pectoris with documented spasm | rpmccmpcm | not risk adjusted |
| I25.762 | Atherosclerosis of bypass graft of coronary artery of transplanted heart with refractory angina pectoris | rpmccmpcm | not risk adjusted |
| I25.768 | Atherosclerosis of bypass graft of coronary artery of transplanted heart with other forms of angina pectoris | rpmccmpcm | not risk adjusted |
| I25.769 | Atherosclerosis of bypass graft of coronary artery of transplanted heart with unspecified angina pectorislow specificity | rpmccmpcm | not risk adjusted |
| I25.790 | Atherosclerosis of other coronary artery bypass graft(s) with unstable angina pectoris | rpmccmpcm | HCC 229 · Unstable Angina and Other Acute Ischemic Heart Disease |
| I25.791 | Atherosclerosis of other coronary artery bypass graft(s) with angina pectoris with documented spasm | rpmccmpcm | not risk adjusted |
| I25.792 | Atherosclerosis of other coronary artery bypass graft(s) with refractory angina pectoris | rpmccmpcm | not risk adjusted |
| I25.798 | Atherosclerosis of other coronary artery bypass graft(s) with other forms of angina pectoris | rpmccmpcm | not risk adjusted |
| I25.799 | Atherosclerosis of other coronary artery bypass graft(s) with unspecified angina pectorislow specificity | rpmccmpcm | not risk adjusted |
| I25.810 | Atherosclerosis of coronary artery bypass graft(s) without angina pectoris | rpmccmpcm | not risk adjusted |
| I25.811 | Atherosclerosis of native coronary artery of transplanted heart without angina pectoris | rpmccmpcm | not risk adjusted |
| I25.812 | Atherosclerosis of bypass graft of coronary artery of transplanted heart without angina pectoris | rpmccmpcm | not risk adjusted |
| I25.82 | Chronic total occlusion of coronary artery | rpmccmpcm | not risk adjusted |
| I25.83 | Coronary atherosclerosis due to lipid rich plaque | rpmccmpcm | not risk adjusted |
| I25.84 | Coronary atherosclerosis due to calcified coronary lesion | rpmccmpcm | not risk adjusted |
| I25.85 | Chronic coronary microvascular dysfunction | rpmccmpcm | not risk adjusted |
| I25.89 | Other forms of chronic ischemic heart disease | rpmccmpcm | not risk adjusted |
| I25.9 | Chronic ischemic heart disease, unspecifiedlow specificity | rpmccmpcm | not risk adjusted |
Myocardial infarction and its sequelae
I21, I22, I23, I25.228 codesrpmccmpcmPost-discharge blood pressure and heart rate surveillance during the highest-risk readmission window.
Myocardial infarction and its sequelae
I21, I22, I23, I25.228 codesrpmccmpcmCMS chronic condition · CCW category: Acute Myocardial Infarction · Devices: Blood pressure cuff, Single-lead ECG
I21 and I22 describe an acute event. For ongoing management most practices carry I25.2 (old myocardial infarction) once the acute episode has closed.
| Code | Official ICD-10-CM description | Programs | Risk adjustment |
|---|---|---|---|
| I21.01 | ST elevation (STEMI) myocardial infarction involving left main coronary artery | rpmccmpcm | HCC 228 · Acute Myocardial Infarction |
| I21.02 | ST elevation (STEMI) myocardial infarction involving left anterior descending coronary artery | rpmccmpcm | HCC 228 · Acute Myocardial Infarction |
| I21.09 | ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall | rpmccmpcm | HCC 228 · Acute Myocardial Infarction |
| I21.11 | ST elevation (STEMI) myocardial infarction involving right coronary artery | rpmccmpcm | HCC 228 · Acute Myocardial Infarction |
| I21.19 | ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall | rpmccmpcm | HCC 228 · Acute Myocardial Infarction |
| I21.21 | ST elevation (STEMI) myocardial infarction involving left circumflex coronary artery | rpmccmpcm | HCC 228 · Acute Myocardial Infarction |
| I21.29 | ST elevation (STEMI) myocardial infarction involving other sites | rpmccmpcm | HCC 228 · Acute Myocardial Infarction |
| I21.3 | ST elevation (STEMI) myocardial infarction of unspecified site | rpmccmpcm | HCC 228 · Acute Myocardial Infarction |
| I21.4 | Non-ST elevation (NSTEMI) myocardial infarction | rpmccmpcm | HCC 228 · Acute Myocardial Infarction |
| I21.9 | Acute myocardial infarction, unspecified | rpmccmpcm | HCC 228 · Acute Myocardial Infarction |
| I21.A1 | Myocardial infarction type 2 | rpmccmpcm | HCC 228 · Acute Myocardial Infarction |
| I21.A9 | Other myocardial infarction type | rpmccmpcm | HCC 228 · Acute Myocardial Infarction |
| I21.B | Myocardial infarction with coronary microvascular dysfunction | rpmccmpcm | HCC 228 · Acute Myocardial Infarction |
| I22.0 | Subsequent ST elevation (STEMI) myocardial infarction of anterior wall | rpmccmpcm | HCC 228 · Acute Myocardial Infarction |
| I22.1 | Subsequent ST elevation (STEMI) myocardial infarction of inferior wall | rpmccmpcm | HCC 228 · Acute Myocardial Infarction |
| I22.2 | Subsequent non-ST elevation (NSTEMI) myocardial infarction | rpmccmpcm | HCC 228 · Acute Myocardial Infarction |
| I22.8 | Subsequent ST elevation (STEMI) myocardial infarction of other sites | rpmccmpcm | HCC 228 · Acute Myocardial Infarction |
| I22.9 | Subsequent ST elevation (STEMI) myocardial infarction of unspecified site | rpmccmpcm | HCC 228 · Acute Myocardial Infarction |
| I23.0 | Hemopericardium as current complication following acute myocardial infarction | rpmccmpcm | HCC 229 · Unstable Angina and Other Acute Ischemic Heart Disease |
| I23.1 | Atrial septal defect as current complication following acute myocardial infarction | rpmccmpcm | HCC 229 · Unstable Angina and Other Acute Ischemic Heart Disease |
| I23.2 | Ventricular septal defect as current complication following acute myocardial infarction | rpmccmpcm | HCC 229 · Unstable Angina and Other Acute Ischemic Heart Disease |
| I23.3 | Rupture of cardiac wall without hemopericardium as current complication following acute myocardial infarction | rpmccmpcm | HCC 229 · Unstable Angina and Other Acute Ischemic Heart Disease |
| I23.4 | Rupture of chordae tendineae as current complication following acute myocardial infarction | rpmccmpcm | HCC 229 · Unstable Angina and Other Acute Ischemic Heart Disease |
| I23.5 | Rupture of papillary muscle as current complication following acute myocardial infarction | rpmccmpcm | HCC 229 · Unstable Angina and Other Acute Ischemic Heart Disease |
| I23.6 | Thrombosis of atrium, auricular appendage, and ventricle as current complications following acute myocardial infarction | rpmccmpcm | HCC 229 · Unstable Angina and Other Acute Ischemic Heart Disease |
| I23.7 | Postinfarction angina | rpmccmpcm | HCC 229 · Unstable Angina and Other Acute Ischemic Heart Disease |
| I23.8 | Other current complications following acute myocardial infarction | rpmccmpcm | HCC 229 · Unstable Angina and Other Acute Ischemic Heart Disease |
| I25.2 | Old myocardial infarction | rpmccmpcm | not risk adjusted |
Stroke, TIA and cerebrovascular sequelae
G45, G46, I63.9, I65, I66, I67, I69.3, I69.9140 codes in familyrpmccmpcmBlood pressure control is the dominant secondary-prevention lever. Activity and fall sensing supports the deficits captured by the I69 sequela codes.
Stroke, TIA and cerebrovascular sequelae
G45, G46, I63.9, I65, I66, I67, I69.3, I69.9140 codes in familyrpmccmpcmCMS chronic condition · CCW category: Stroke/Transient Ischemic Attack · Devices: Blood pressure cuff, Contactless activity and fall radar
I69 codes carry the deficit, so they are usually the ones that justify ongoing care management rather than the acute I63 code.
This family runs to 140 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within G45, G46, I63.9, I65, I66, I67, I69.3, I69.9.
Peripheral and visceral vascular disease
I70, I71, I72, I73, I77, I79318 codes in familyrpmccmpcmBlood pressure and peripheral perfusion, often alongside diabetic foot surveillance.
Peripheral and visceral vascular disease
I70, I71, I72, I73, I77, I79318 codes in familyrpmccmpcmCMS other chronic or potentially disabling condition · CCW category: Peripheral Vascular Disease (PVD) · Devices: Blood pressure cuff, Pulse oximeter
This family runs to 318 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within I70, I71, I72, I73, I77, I79.
Pulmonary heart disease and pulmonary hypertension
I2717 codesrpmccmpcmOxygen saturation and weight, since right heart failure presents as fluid gain.
Pulmonary heart disease and pulmonary hypertension
I2717 codesrpmccmpcmAdded by CCN Health · Devices: Pulse oximeter, Connected weight scale, Blood pressure cuff
| Code | Official ICD-10-CM description | Programs | Risk adjustment |
|---|---|---|---|
| I27.0 | Primary pulmonary hypertension | rpmccmpcm | HCC 226 · Heart Failure, Except End-Stage and Acute |
| I27.1 | Kyphoscoliotic heart disease | rpmccmpcm | HCC 226 · Heart Failure, Except End-Stage and Acute |
| I27.20 | Pulmonary hypertension, unspecified | rpmccmpcm | HCC 226 · Heart Failure, Except End-Stage and Acute |
| I27.21 | Secondary pulmonary arterial hypertension | rpmccmpcm | HCC 226 · Heart Failure, Except End-Stage and Acute |
| I27.22 | Pulmonary hypertension due to left heart disease | rpmccmpcm | HCC 226 · Heart Failure, Except End-Stage and Acute |
| I27.23 | Pulmonary hypertension due to lung diseases and hypoxia | rpmccmpcm | HCC 226 · Heart Failure, Except End-Stage and Acute |
| I27.24 | Chronic thromboembolic pulmonary hypertension | rpmccmpcm | HCC 226 · Heart Failure, Except End-Stage and Acute |
| I27.29 | Other secondary pulmonary hypertension | rpmccmpcm | HCC 226 · Heart Failure, Except End-Stage and Acute |
| I27.81 | Cor pulmonale (chronic) | rpmccmpcm | HCC 226 · Heart Failure, Except End-Stage and Acute |
| I27.82 | Chronic pulmonary embolism | rpmccmpcm | HCC 267 · Deep Vein Thrombosis and Pulmonary Embolism |
| I27.83 | Eisenmenger's syndrome | rpmccmpcm | HCC 226 · Heart Failure, Except End-Stage and Acute |
| I27.840 | Fontan-associated liver disease [FALD] | rpmccmpcm | not risk adjusted |
| I27.841 | Fontan-associated lymphatic dysfunction | rpmccmpcm | not risk adjusted |
| I27.848 | Other Fontan-associated condition | rpmccmpcm | not risk adjusted |
| I27.849 | Fontan related circulation, unspecifiedlow specificity | rpmccmpcm | not risk adjusted |
| I27.89 | Other specified pulmonary heart diseases | rpmccmpcm | HCC 226 · Heart Failure, Except End-Stage and Acute |
| I27.9 | Pulmonary heart disease, unspecified | rpmccmpcm | HCC 226 · Heart Failure, Except End-Stage and Acute |
Other chronic and potentially disabling
Transplant status and long-term drug therapy
Z94, Z79.4, Z79.01, Z79.02, Z79.899, Z91.1420 codesrpmccmpcmBlood pressure, weight and temperature for graft surveillance, with adherence tracking.
Transplant status and long-term drug therapy
Z94, Z79.4, Z79.01, Z79.02, Z79.899, Z91.1420 codesrpmccmpcmAdded by CCN Health · Devices: Blood pressure cuff, Connected weight scale, Connected thermometer, Blood glucose meter
These are status and secondary codes. They support medical necessity but never stand alone as the reason for the service.
| Code | Official ICD-10-CM description | Programs | Risk adjustment |
|---|---|---|---|
| Z79.01 | Long term (current) use of anticoagulants | rpmccmpcm | not risk adjusted |
| Z79.02 | Long term (current) use of antithrombotics/antiplatelets | rpmccmpcm | not risk adjusted |
| Z79.4 | Long term (current) use of insulin | rpmccmpcm | HCC 38 · Diabetes with Glycemic, Unspecified, or No Complications |
| Z79.899 | Other long term (current) drug therapy | rpmccmpcm | not risk adjusted |
| Z91.141 | Patient's other noncompliance with medication regimen due to financial hardship | rpmccmpcm | not risk adjusted |
| Z91.148 | Patient's other noncompliance with medication regimen for other reason | rpmccmpcm | not risk adjusted |
| Z94.0 | Kidney transplant status | rpmccmpcm | not risk adjusted |
| Z94.1 | Heart transplant status | rpmccmpcm | HCC 221 · Heart Transplant Status/Complications |
| Z94.2 | Lung transplant status | rpmccmpcm | HCC 276 · Lung Transplant Status/Complications |
| Z94.3 | Heart and lungs transplant status | rpmccmpcm | HCC 221 · Heart Transplant Status/Complications |
| Z94.4 | Liver transplant status | rpmccmpcm | HCC 62 · Liver Transplant Status/Complications |
| Z94.5 | Skin transplant status | rpmccmpcm | not risk adjusted |
| Z94.6 | Bone transplant status | rpmccmpcm | not risk adjusted |
| Z94.7 | Corneal transplant status | rpmccmpcm | not risk adjusted |
| Z94.81 | Bone marrow transplant status | rpmccmpcm | HCC 454 · Stem Cell, Including Bone Marrow, Transplant Status/Complications |
| Z94.82 | Intestine transplant status | rpmccmpcm | HCC 77 · Intestine Transplant Status/Complications |
| Z94.83 | Pancreas transplant status | rpmccmpcm | HCC 35 · Pancreas Transplant Status |
| Z94.84 | Stem cells transplant status | rpmccmpcm | HCC 454 · Stem Cell, Including Bone Marrow, Transplant Status/Complications |
| Z94.89 | Other transplanted organ and tissue status | rpmccmpcm | not risk adjusted |
| Z94.9 | Transplanted organ and tissue status, unspecifiedlow specificity | rpmccmpcm | not risk adjusted |
No codes match those filters. Clear a filter to widen the search.
Clinical Context
Why cardiology practices benefit from PCM.
Cardiology practices can leverage PCM to improve patient outcomes through structured care management, generating $97–$220+ per patient per month in Medicare reimbursement while reducing avoidable hospitalizations.
Related Conditions
Condition monitoring guides.
FAQ
Common questions.
What ICD-10 codes qualify cardiology patients for PCM?
CMS publishes no list of codes that qualify a patient for PCM: eligibility turns on the condition and on documented medical necessity. For cardiology, 197 billable ICD-10-CM codes cover the conditions PCM manages, spanning 11 conditions including essential hypertension, hypertensive heart and kidney disease, heart failure, cardiomyopathy and myocarditis, atrial fibrillation and flutter, ischemic heart disease.
How does CCN Health support cardiology practices with PCM?
CCN Health provides turnkey PCM services for cardiology practices, including patient eligibility identification, enrollment documentation, device provisioning, clinical monitoring, and full Medicare billing support.
What is the revenue potential for PCM in cardiology?
Reimbursement varies by locality and payer contract, so see the PCM billing guide for current figures. Cardiology practices with a high prevalence of these conditions generally see the most benefit, particularly when PCM is combined with RPM and BHI for patients whose needs are distinct enough to document separately.
Sources & Compliance
Code set. Every code on this page is drawn from the official ICD-10-CM ICD-10-CM FY2026 (valid 2025-10-01 through 2026-09-30) released by CDC/NCHS, and only codes flagged valid for submission are listed. ICD-10-CM is published by the federal government and is in the public domain, so the descriptions here are the official long descriptors reproduced verbatim rather than summarized. The next code set, ICD-10-CM FY2027 (valid from 2026-10-01), is already reflected in the change flags.
Eligibility is not a code list. CMS does not publish a list of ICD-10 codes that qualify a patient for RPM, CCM, PCM, BHI, or RTM. Eligibility turns on the condition and on documented medical necessity. The programs shown against each condition are CCN Health’s clinical assessment of which programs that condition can support, not a statement of CMS approval.
Risk adjustment. HCC labels and category assignments come from the CMS-HCC V28 model for the 2026 payment year. Risk adjustment depends on the full encounter record, not on a single code, and the flags here are a prompt to check specificity rather than a payment guarantee.
CPT® notice. CPT is a registered trademark of the American Medical Association. CPT codes, descriptions, and other data only are copyright 2026 American Medical Association. All rights reserved. CPT is provided “as is” without warranty of any kind.
Sources. ICD-10-CM files, CDC/NCHS (cdc.gov); CMS Chronic Conditions Data Warehouse condition categories (ccwdata.org); CMS-HCC risk adjustment model software and ICD-10 mappings (cms.gov); AHRQ Clinical Classifications Software Refined (ahrq.gov).
Disclaimer. This page is informational and does not constitute billing, clinical, or legal advice. Diagnosis coding must reflect the documentation in the medical record. Verify all codes against the official CMS and CDC/NCHS publications and your contracted payer agreements before billing.