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What is the insurance diagnosis code used for pulmonary arterial hypertension (PAH) when being prescribed sildenafil?

The ICD-10 diagnosis code for pulmonary arterial hypertension is I27.0 (Primary pulmonary hypertension). This is the code most commonly used when sildenafil (brand name Revatio, when prescribed specifically Show Full Answer

What is the insurance diagnosis code used for pulmonary arterial hypertension (PAH) when being prescribed sildenafil?

The ICD-10 diagnosis code for pulmonary arterial hypertension is I27.0 (Primary pulmonary hypertension). This is the code most commonly used when sildenafil (brand name Revatio, when prescribed specifically for PAH) is submitted to insurance.

It's worth noting that sildenafil under the brand name Viagra is typically coded differently and may not be covered for PAH — so making sure your doctor submits it as Revatio with code I27.0 is important.

A few tips to help with insurance coverage:

- Confirm with your prescribing doctor that the code I27.0 is on the prescription and prior authorization request
- Ask your doctor's office to specify the medication as Revatio (not Viagra) for PAH treatment
- Request a prior authorization if your insurer requires one
- Contact your insurance provider directly to confirm coverage requirements

If you're running into coverage issues, your PAH specialist's office often has staff experienced in navigating these approvals — they can be a great ally in this process!

 AI-generated responses are not a substitute for medical advice. These services are not intended to diagnose, treat, or cure any condition or disease. Always ask your doctor about specific health concerns.

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