I01.0

I01.0: Acute rheumatic pericarditis

Billable / specific codeICD-10-CM

I01.0 is a billable, specific ICD-10-CM code for acute rheumatic pericarditis. It is valid for submission on a claim.

Check I01.0 with the rest of the claim: free scrubber

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)

Excludes1 inherited from the categories above I01.0

A category’s note binds every code beneath it.

Written on I01: Rheumatic fever with heart involvement

chronic diseases of rheumatic origin (I05-I09) unless rheumatic fever is also present or there is evidence of reactivation or activity of the rheumatic process.

Other codes that can never be billed with I01.0

Their own Excludes1 notes name this code, so the conflict is not listed above.

I00Rheumatic fever without heart involvement
I30Acute pericarditis

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

I01.0 is named in 11 Medicare coverage policies: 11 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

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

Alphabetic index entries that lead here

Pericarditis›rheumatic(active) (acute) (with effusion) (with pneumonia)
Rheumatic›pericarditis(active) (acute) (with effusion) (with pneumonia)
Pericarditis›acute›rheumatic

Code history

Unchanged in every release from FY2024 to FY2027.