I28: Other diseases of pulmonary vessels

I28 refers to Other diseases of pulmonary vessels, a set of cardiovascular conditions that primarily affect the pulmonary arteries and the right side of the heart. These include life-threatening issues like pulmonary embolism (I26) and chronic conditions such as pulmonary hypertension or congenital pulmonary artery anomalies (I27, I28).

Symptoms

• Sudden shortness of breath – Hallmark of pulmonary embolism (I26)
• Chest pain – Often pleuritic in embolism, or pressure-like in pulmonary hypertension
• Hemoptysis (coughing blood) – May occur with embolic infarction
• Fatigue and exertional dyspnea – Common in chronic pulmonary heart disease (I27)
• Syncope or lightheadedness – Due to right heart strain or hypoxia
• Peripheral edema – Seen in cor pulmonale and chronic right heart failure
• Cyanosis – Suggests severe hypoxemia or shunt physiology

Diagnosis

Diagnosis of Other diseases of pulmonary vessels involves clinical suspicion, D-dimer tests, CT pulmonary angiography, echocardiography, right heart catheterization (for I27), and V/Q scan. ECG and chest X-rays are used adjunctively to assess heart strain or underlying structural abnormalities.

ICD10 Code Usage

ICD10 code I28 is used by pulmonologists, cardiologists, emergency physicians, and internists. It supports documentation for acute interventions, chronic disease management, long-term anticoagulation, right heart catheterization, and eligibility for medications like endothelin receptor antagonists or thrombolytics.

Related Codes

• I26 – Pulmonary embolism
• I27 – Other pulmonary heart diseases

FAQs

Q1: What is ICD10 code I28?
A: It represents Other diseases of pulmonary vessels, which includes acute pulmonary embolism, chronic pulmonary hypertension, or structural diseases affecting pulmonary vessels.

Q2: How serious is a pulmonary embolism (I26)?
A: It can be fatal if untreated, but survival is high with timely anticoagulation or thrombolytic therapy.

Q3: What causes pulmonary hypertension (I27)?
A: Chronic lung disease, left heart failure, recurrent clots, or idiopathic vascular remodeling.

Q4: What is included under I28?
A: Rare vascular abnormalities such as arteriovenous malformations, aneurysms, or pulmonary vasculitis.

Q5: Who manages these conditions?
A: Acute cases are managed in emergency or ICU; chronic pulmonary vascular diseases are typically handled by pulmonologists or cardiologists.

Conclusion

ICD10 code I28 enables accurate classification of Other diseases of pulmonary vessels, supporting early diagnosis, critical intervention, and long-term pulmonary and cardiac care for patients with vascular involvement of the lungs.