I09.1
I09.1: Rheumatic diseases of endocardium, valve unspecified
Billable / specific codeICD-10-CM
I09.1 is a billable, specific ICD-10-CM code for rheumatic diseases of endocardium, valve unspecified. It is valid for submission on a claim.
Check I09.1 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- endocarditis, valve unspecified (I38)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Rheumatic endocarditis (chronic)
- Rheumatic valvulitis (chronic)
Other codes that can never be billed with I09.1
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
I09.1 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
- A52868Billing and Coding: Transesophageal Echocardiography (TEE)
- A56476Billing and Coding: Cardiac Radionuclide Imaging
- A56500Billing and Coding: Cardiac Catheterization and Coronary Angiography
Alphabetic index entries that lead here
- Endocarditis›rheumatic(chronic) (inactive) (with chorea)
- Endocarditis›with rheumatic fever›inactive or quiescent(with chorea)
- Fever›rheumatic›inactive or quiescent with›endocarditis
Code history
Unchanged in every release from FY2024 to FY2027.