Cement & Fat Pulmonary Artery Embolisms

New Codes (I26.03 and I26.04) have been created at subcategory I26.0.

(Valid for October 1, 2024 discharges)

I26.0 Pulmonary embolism with acute cor pulmonale:

• I26.03 to capture cement embolism of pulmonary artery with acute cor pulmonale
• I26.04 fat embolism of pulmonary artery with acute cor pulmonale

About Cement and Fat Pulmonary Artery Embolisms: 

Pulmonary cement embolism (PCE) is an iatrogenic condition where bone cement made from polymethyl methacrylate (PMMA), that is used during procedures such as vertebroplasty/kyphoplasty, leaks into the venous system and subsequently hardens creating a PCE.

PCEs are considered mechanical occlusions, not blood clots, and they are managed differently from pulmonary embolisms.

Treatment depends on the severity of symptoms. For asymptomatic patients, supportive care and observation are typically recommended. However, for symptomatic patients, treatment options could include surgical interventions.

Fat embolism (FE) and fat embolism syndrome (FES) occur when one or more droplet-like particles of fat enter the bloodstream and blocks the systemic or pulmonary circulatory system. Frequent causes of fat emboli are acute fractures of major bones such as a pelvic bone or the long bones. FEs can also occur following orthopedic surgery, such as hip or knee replacement. Non-traumatic causes of FEs include pancreatitis, sickle cell disease, and alcoholic and fatty liver disease.

Like PCE, a fat embolism is not considered a blood clot, however, fat blockages can affect the blood vessels of the skin, heart, kidneys, eyes, and lung. Pulmonary artery FEs can cause difficulty breathing and chest discomfort. Treatment is typically supportive care that addresses any associated symptoms.

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