A36.81 — Diphtheritic cardiomyopathy
A36.81 is a billable, specific ICD-10-CM code for diphtheritic cardiomyopathy. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Diphtheritic myocarditis
Other codes that can never be billed with A36.81
These codes carry an Excludes1 note pointing at A36.81. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading A36.81 alone.
Risk adjustment
A36.81 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 227 Cardiomyopathy/Myocarditis0.189 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
A36.81 is named in 4 Medicare coverage policies — 4 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56781Billing and Coding: Transthoracic Echocardiography (TTE)
- A56900Billing and Coding: Immunizations
- A57306Billing and Coding: Transthoracic Echocardiography (TTE)
- A57326Billing and Coding: Electrocardiograms
How A36.81 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to A36.81.
- Diphtheria, diphtheritic›myocarditis
- Myocarditis›diphtheritic
- Myocarditis›in›diphtheria
Related codes at this level
Codes that share A36.8. If A36.81 is not quite right, the correct code is usually one of these.
Questions about A36.81
- Is A36.81 a billable ICD-10-CM code?
- Yes. A36.81 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does A36.81 sit in the tabular list?
- Certain infectious and parasitic diseases (A00-B99), in the block Other bacterial diseases (A30-A49).