I27.849: Fontan related circulation, unspecified
I27.849, fontan related circulation, unspecified, is listed as a covered diagnosis in 6 Medicare billing and coding articles that apply to 36 HCPCS Level II codes, including J0153 (Injection, adenosine, 1 mg (not to be used to report any…), J1250 (Injection, dobutamine hydrochloride, per 250 mg), J1245 (Injection, dipyridamole, per 10 mg). The articles come from 2 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 I27.849 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| J0153 | Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds) | Special coverage instructions apply | — | 3 |
| J1250 | Injection, dobutamine hydrochloride, per 250 mg | Special coverage instructions apply | — | 3 |
| J1245 | Injection, dipyridamole, per 10 mg | Special coverage instructions apply | — | 3 |
| G0238 | Therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring) | Carrier judgment | — | 2 |
| G0237 | Therapeutic procedures to increase strength or endurance of respiratory muscles, face to face, one on one, each 15 minutes (includes monitoring) | Carrier judgment | — | 2 |
| G0239 | Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring) | Carrier judgment | — | 2 |
| J0461 | Injection, atropine sulfate, 0.01 mg | Special coverage instructions apply | — | 2 |
| J0280 | Injection, aminophyllin, up to 250 mg | Special coverage instructions apply | — | 2 |
| J3490 | Unclassified drugs | Special coverage instructions apply | — | 1 |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | Carrier judgment | — | 1 |
| A9502 | Technetium tc-99m tetrofosmin, diagnostic, per study dose | Carrier judgment | — | 1 |
| A9555 | Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries | Carrier judgment | — | 1 |
| A9505 | Thallium tl-201 thallous chloride, diagnostic, per millicurie | Carrier judgment | — | 1 |
| A9526 | Nitrogen n-13 ammonia, diagnostic, per study dose, up to 40 millicuries | Carrier judgment | — | 1 |
| A4641 | Radiopharmaceutical, diagnostic, not otherwise classified | Carrier judgment | — | 1 |
| A9501 | Technetium tc-99m teboroxime, diagnostic, per study dose | Carrier judgment | — | 1 |
| A9611 | Flurpiridaz f 18, diagnostic, 1 millicurie | Carrier judgment | — | 1 |
| C8900 | Magnetic resonance angiography with contrast, abdomen | Special coverage instructions apply | — | 1 |
| C8901 | Magnetic resonance angiography without contrast, abdomen | Special coverage instructions apply | — | 1 |
| C8902 | Magnetic resonance angiography without contrast followed by with contrast, abdomen | Special coverage instructions apply | — | 1 |
| C8909 | Magnetic resonance angiography with contrast, chest (excluding myocardium) | Special coverage instructions apply | — | 1 |
| C8910 | Magnetic resonance angiography without contrast, chest (excluding myocardium) | Special coverage instructions apply | — | 1 |
| C8911 | Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium) | Special coverage instructions apply | — | 1 |
| C8912 | Magnetic resonance angiography with contrast, lower extremity | Special coverage instructions apply | — | 1 |
| C8913 | Magnetic resonance angiography without contrast, lower extremity | Special coverage instructions apply | — | 1 |
11 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing I27.849
- A57183: Billing and Coding: Cardiovascular Stress Testing, Including Exercise and/or Pharmacological Stress and Stress Echocardiography (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 4 Level II codes). LCD with the same title: L34324
- A56476: Billing and Coding: Cardiac Radionuclide Imaging (Palmetto GBA (MAC - Part A, MAC - Part B); 13 Level II codes). LCD with the same title: L33457
- A56717: Billing and Coding: Respiratory Therapy (Respiratory Care) (Palmetto GBA (MAC - Part A); 3 Level II codes). LCD with the same title: L34430
- A57224: Billing and Coding: Respiratory Care (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L34149
- A56775: Billing and Coding: Magnetic Resonance Angiography (Palmetto GBA (MAC - Part A, MAC - Part B); 18 Level II codes). LCD with the same title: L34424
- A56625: Billing and Coding: Echocardiography (Palmetto GBA (MAC - Part A, MAC - Part B); 6 Level II codes). LCD with the same title: L37379
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 I27 diagnoses (Other pulmonary heart diseases)
- I27.840 — Fontan-associated liver disease [FALD]
- I27.841 — Fontan-associated lymphatic dysfunction
- I27.848 — Other Fontan-associated condition
- I27.81 — Cor pulmonale (chronic)
- I27.82 — Chronic pulmonary embolism
- I27.83 — Eisenmenger's syndrome
- I27.89 — Other specified pulmonary heart diseases
- I27.0 — Primary pulmonary hypertension
- I27.1 — Kyphoscoliotic heart disease
- I27.20 — Pulmonary hypertension, unspecified
- I27.21 — Secondary pulmonary arterial hypertension
- I27.22 — Pulmonary hypertension due to left heart disease
- I27.23 — Pulmonary hypertension due to lung diseases and hypoxia
- I27.24 — Chronic thromboembolic pulmonary hypertension
- I27.29 — Other secondary pulmonary hypertension
- I27.9 — Pulmonary heart disease, unspecified
Frequently asked questions
Does Medicare cover I27.849 (Fontan related circulation, unspecified)?
Medicare covers items and services, not diagnoses. 6 Medicare billing and coding articles list I27.849 as a covered diagnosis for 36 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 I27.849?
The Level II codes from the policies most specific to this diagnosis are J0153 (Injection, adenosine, 1 mg (not to be used to report any…, 3 articles); J1250 (Injection, dobutamine hydrochloride, per 250 mg, 3 articles); J1245 (Injection, dipyridamole, per 10 mg, 3 articles); G0238 (Therapeutic procedures to improve respiratory function…, 2 articles); G0237 (Therapeutic procedures to increase strength or endurance…, 2 articles). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list I27.849?
A57183 (Billing and Coding: Cardiovascular Stress Testing, Including Exercise and/or Pharmacological Stress and Stress Echocardiography); A56476 (Billing and Coding: Cardiac Radionuclide Imaging); A56717 (Billing and Coding: Respiratory Therapy (Respiratory Care)), and 3 more articles.
What is ICD-10-CM code I27.849?
I27.849 is the ICD-10-CM code for fontan related circulation, unspecified, in category I27 (Other pulmonary heart diseases), chapter 9: Diseases of the circulatory system.
Next steps
- Run a reimbursement report for a device billed under J0153
- Watch J0153 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0153
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