I01.0 — Acute rheumatic pericarditis
I01.0 is a billable, specific ICD-10-CM code for acute rheumatic pericarditis. It is valid for submission on a claim.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- acute pericarditis not specified as rheumatic (I30.-)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Any condition in I00 with pericarditis
- Rheumatic pericarditis (acute)
Other codes that can never be billed with I01.0
These codes carry an Excludes1 note pointing at I01.0. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading I01.0 alone.
Risk adjustment
I01.0 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
I01.0 is named in 13 Medicare coverage policies — 13 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
- A56500Billing and Coding: Cardiac Catheterization and Coronary Angiography
- A56505Billing and Coding: Transesophageal Echocardiography (TEE)
- A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
How I01.0 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 I01.0.
- Pericarditis›rheumatic(active) (acute) (with effusion) (with pneumonia)
- Rheumatic›pericarditis(active) (acute) (with effusion) (with pneumonia)
- Pericarditis›acute›rheumatic
Related codes at this level
Codes that share I01. If I01.0 is not quite right, the correct code is usually one of these.
Questions about I01.0
- Is I01.0 a billable ICD-10-CM code?
- Yes. I01.0 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does I01.0 sit in the tabular list?
- Diseases of the circulatory system (I00-I99), in the block Acute rheumatic fever (I00-I02).
- What cannot be coded together with I01.0?
- I01.0 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.