I01.1 — Acute rheumatic endocarditis
I01.1 is a billable, specific ICD-10-CM code for acute rheumatic endocarditis. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Any condition in I00 with endocarditis or valvulitis
- Acute rheumatic valvulitis
Other codes that can never be billed with I01.1
These codes carry an Excludes1 note pointing at I01.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading I01.1 alone.
- I33Acute and subacute endocarditis
Risk adjustment
I01.1 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
I01.1 is named in 15 Medicare coverage policies — 15 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
- A52868Billing and Coding: Transesophageal Echocardiography (TEE)
- A56500Billing and Coding: Cardiac Catheterization and Coronary Angiography
- A56505Billing and Coding: Transesophageal Echocardiography (TEE)
How I01.1 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 I01.1.
- Endocarditis›acute or subacute›rheumatic(aortic) (mitral) (pulmonary) (tricuspid)
- Endocarditis›mitral›active or acute
- Endocarditis›rheumatic›active or acute(aortic) (mitral) (pulmonary) (tricuspid)
- Endocarditis›tricuspid›active or acute
- Stenosis, stenotic›mitral›active or acute
- Endocarditis›aortic›rheumatic›active or acute
- Endocarditis›pulmonary›acute or subacute›rheumatic
- Endocarditis›pulmonary›rheumatic›active or acute
- Insufficiency, insufficient›mitral›rheumatic›active or acute
- Endocarditis›aortic›rheumatic›with mitral disease›active or acute
- Endocarditis›aortic›with›mitral disease›active or acute
- Endocarditis›mitral›with›aortic disease›active or acute
Related codes at this level
Codes that share I01. If I01.1 is not quite right, the correct code is usually one of these.
Questions about I01.1
- Is I01.1 a billable ICD-10-CM code?
- Yes. I01.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does I01.1 sit in the tabular list?
- Diseases of the circulatory system (I00-I99), in the block Acute rheumatic fever (I00-I02).