New code · FY2027
Billable: use this code on claims.
- New code, effective October 1, 2026 (FY2027). Before that, this condition was coded as I42.8.
Code breakdown
I42.81
- I42CategoryCardiomyopathy
- 8Character 4Other cardiomyopathies
- 1Character 5Arrhythmogenic cardiomyopathy
Coding notes
Includes (from I42)
- myocardiopathy
Excludes2 (from I42)
- ischemic cardiomyopathy (I25.5)
- peripartum cardiomyopathy (O90.3)
- ventricular hypertrophy (I51.7)
Code first (from I42)
- pre-existing cardiomyopathy complicating pregnancy and puerperium (O99.4)
Medicare coverage
I42.81 is listed as a covered diagnosis in 32 Medicare billing and coding articles:
- A52850 Billing and Coding: Cardiac Catheterization and Coronary Angiography
- A52868 Billing and Coding: Transesophageal Echocardiography (TEE)
- A56391 Billing and Coding: Implantable Automatic Defibrillators
- A56476 Billing and Coding: Cardiac Radionuclide Imaging
- A56500 Billing and Coding: Cardiac Catheterization and Coronary Angiography
- A56505 Billing and Coding: Transesophageal Echocardiography (TEE)
- A56580 Billing and Coding: Computerized Axial Tomography (CT), Thorax
- A56605 Billing and Coding: B-type Natriuretic Peptide (BNP) Testing
- A56625 Billing and Coding: Echocardiography
- A56691 Billing and Coding: Cardiac Computed Tomography & Angiography (CCTA)
…and 22 more. Check the coverage tool for your CPT code.
Check this code
- Code search: full entry and nearby codes
- Excludes checker: can it be billed with another code?
- Coverage checker: is it covered for your CPT code?
ICD-10-CM codes and descriptions are from the CMS and NCHS code files. Coverage is from the CMS Medicare Coverage Database billing and coding articles.