I26.04: Fat embolism of pulmonary artery with acute cor pulmonale

I26.04, fat embolism of pulmonary artery with acute cor pulmonale, is listed as a covered diagnosis in 10 Medicare billing and coding articles that apply to 53 HCPCS Level II codes, including C8925 (Transesophageal echocardiography (tee) with contrast, or…), C8926 (Transesophageal echocardiography (tee) with contrast, or…), C8927 (Transesophageal echocardiography (tee) with contrast, or…). The articles come from 5 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.

HCPCS Level II codes with I26.04 as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
C8925Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, real time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and reportSpecial coverage instructions apply—2
C8926Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and reportSpecial coverage instructions apply—2
C8927Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (dynamically changing) cardiac pumping function and to therapeutic measures on an immediate time basisSpecial coverage instructions apply—2
J0461Injection, atropine sulfate, 0.01 mgSpecial coverage instructions apply—3
J0153Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds)Special coverage instructions apply—3
J1250Injection, dobutamine hydrochloride, per 250 mgSpecial coverage instructions apply—3
J0280Injection, aminophyllin, up to 250 mgSpecial coverage instructions apply—3
J1245Injection, dipyridamole, per 10 mgSpecial coverage instructions apply—3
Q9957Injection, perflutren lipid microspheres, per mlCarrier judgment—2
Q9956Injection, octafluoropropane microspheres, per mlCarrier judgment—2
Q9955Injection, perflexane lipid microspheres, per mlCarrier judgment—2
G0238Therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring)Carrier judgment—2
G0237Therapeutic procedures to increase strength or endurance of respiratory muscles, face to face, one on one, each 15 minutes (includes monitoring)Carrier judgment—2
G0239Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring)Carrier judgment—2
C8900Magnetic resonance angiography with contrast, abdomenSpecial coverage instructions apply—2
C8901Magnetic resonance angiography without contrast, abdomenSpecial coverage instructions apply—2
C8902Magnetic resonance angiography without contrast followed by with contrast, abdomenSpecial coverage instructions apply—2
C8909Magnetic resonance angiography with contrast, chest (excluding myocardium)Special coverage instructions apply—2
C8910Magnetic resonance angiography without contrast, chest (excluding myocardium)Special coverage instructions apply—2
C8911Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium)Special coverage instructions apply—2
C8912Magnetic resonance angiography with contrast, lower extremitySpecial coverage instructions apply—2
C8913Magnetic resonance angiography without contrast, lower extremitySpecial coverage instructions apply—2
C8914Magnetic resonance angiography without contrast followed by with contrast, lower extremitySpecial coverage instructions apply—2
C8918Magnetic resonance angiography with contrast, pelvisSpecial coverage instructions apply—2
C8919Magnetic resonance angiography without contrast, pelvisSpecial coverage instructions apply—2

28 more codes are listed. See every code with payment by region in Caduvo.

Medicare policy articles listing I26.04

A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.

Other I26 diagnoses (Pulmonary embolism)

Frequently asked questions

Does Medicare cover I26.04 (Fat embolism of pulmonary artery with acute cor pulmonale)?

Medicare covers items and services, not diagnoses. 10 Medicare billing and coding articles list I26.04 as a covered diagnosis for 53 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.

Which HCPCS codes can be billed with ICD-10 I26.04?

The Level II codes from the policies most specific to this diagnosis are C8925 (Transesophageal echocardiography (tee) with contrast, or…, 2 articles); C8926 (Transesophageal echocardiography (tee) with contrast, or…, 2 articles); C8927 (Transesophageal echocardiography (tee) with contrast, or…, 2 articles); J0461 (Injection, atropine sulfate, 0.01 mg, 3 articles); J0153 (Injection, adenosine, 1 mg (not to be used to report any…, 3 articles). Code choice depends on the item supplied; check each code's descriptor.

Which Medicare policy articles list I26.04?

A57179 (Billing and Coding: Transesophageal Echocardiogram); A56505 (Billing and Coding: Transesophageal Echocardiography (TEE)); A56500 (Billing and Coding: Cardiac Catheterization and Coronary Angiography), and 7 more articles.

What is ICD-10-CM code I26.04?

I26.04 is the ICD-10-CM code for fat embolism of pulmonary artery with acute cor pulmonale, in category I26 (Pulmonary embolism), chapter 9: Diseases of the circulatory system.

Next steps

Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.

Chapter 9: Diseases of the circulatory system · All diagnoses · HCPCS lookup