Is I01.9 a billable ICD-10-CM code?

Yes. I01.9 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does I01.9 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 I01.9?

I01.9 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above I01.9 (I01) and apply to it just the same.

I01.9

I01.9 — Acute rheumatic heart disease, unspecified

Billable / specific codeICD-10-CM

I01.9 is a billable, specific ICD-10-CM code for acute rheumatic heart disease, unspecified. 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 unspecified type of heart involvement
Rheumatic carditis, acute
Rheumatic heart disease, active or acute

Excludes1 inherited from the categories above I01.9

These are not written on I01.9, but they bind it: a note on a category applies to every code beneath it. Billing I01.9 with anything listed here is a denial.

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 I01.9

These codes carry an Excludes1 note pointing at I01.9. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading I01.9 alone.

I00Rheumatic fever without heart involvement

Risk adjustment

I01.9 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

I01.9 is named in 6 Medicare coverage policies — 6 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
A56625Billing and Coding: Echocardiography
A56781Billing and Coding: Transthoracic Echocardiography (TTE)
A57179Billing and Coding: Transesophageal Echocardiogram

How I01.9 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 I01.9.

Bouillaud's disease or syndrome(rheumatic heart disease)
Disease, diseased›Bouillaud's(rheumatic heart disease)
Syndrome›Bouillaud's
Disease, diseased›heart›rheumatic›active or acute
Disease, diseased›heart›with›rheumatic fever›active

Code history

I01.9 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share I01. If I01.9 is not quite right, the correct code is usually one of these.

Questions about I01.9

Is I01.9 a billable ICD-10-CM code?: Yes. I01.9 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does I01.9 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 I01.9?: I01.9 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above I01.9 (I01) and apply to it just the same.