Is I09.0 a billable ICD-10-CM code?

Yes. I09.0 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does I09.0 sit in the tabular list?

Diseases of the circulatory system (I00-I99), in the block Chronic rheumatic heart diseases (I05-I09).

What cannot be coded together with I09.0?

I09.0 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

I09.0

I09.0 — Rheumatic myocarditis

Billable / specific codeICD-10-CM

I09.0 is a billable, specific ICD-10-CM code for rheumatic myocarditis. 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.

myocarditis not specified as rheumatic (I51.4)

Risk adjustment

I09.0 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

I09.0 is named in 17 Medicare coverage policies — 17 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
A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
A52868Billing and Coding: Transesophageal Echocardiography (TEE)
A56476Billing and Coding: Cardiac Radionuclide Imaging

How I09.0 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 I09.0.

Cardiomyopathy›rheumatic
Myocarditis›rheumatic(chronic) (inactive) (with chorea)
Rheumatic›degeneration, myocardium
Rheumatic›myocarditis(chronic) (inactive) (with chorea)
Degeneration, degenerative›myocardial, myocardium›with rheumatic fever(conditions in I00)
Insufficiency, insufficient›myocardial, myocardium›rheumatic
Myocarditis›with›rheumatic fever(conditions in I00)
Degeneration, degenerative›myocardial, myocardium›with rheumatic fever›inactive or quiescent(with chorea)
Fever›rheumatic›inactive or quiescent with›myocarditis, myocardial degeneration(conditions in I51.4)
Insufficiency, insufficient›myocardial, myocardium›with›rheumatic fever(conditions in I00)
Myocarditis›with›rheumatic fever›inactive or quiescent(with chorea)
Insufficiency, insufficient›myocardial, myocardium›with›rheumatic fever›inactive or quiescent(with chorea)

Related codes at this level

Codes that share I09. If I09.0 is not quite right, the correct code is usually one of these.

Questions about I09.0

Is I09.0 a billable ICD-10-CM code?: Yes. I09.0 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does I09.0 sit in the tabular list?: Diseases of the circulatory system (I00-I99), in the block Chronic rheumatic heart diseases (I05-I09).
What cannot be coded together with I09.0?: I09.0 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.