Is I30.1 a billable ICD-10-CM code?

Yes. I30.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does I30.1 sit in the tabular list?

Diseases of the circulatory system (I00-I99), in the block Other forms of heart disease (I30-I5A).

I30.1

I30.1 — Infective pericarditis

Billable / specific codeICD-10-CM

I30.1 is a billable, specific ICD-10-CM code for infective pericarditis. It is valid for submission on a claim.

Use additional code

Add a secondary code to capture the detail described below.

code (B95-B97) to identify infectious agent

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Pneumococcal pericarditis
Pneumopyopericardium
Purulent pericarditis
Pyopericarditis
Pyopericardium
Pyopneumopericardium
Staphylococcal pericarditis
Streptococcal pericarditis
Suppurative pericarditis
Viral pericarditis

Risk adjustment

I30.1 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

I30.1 is named in 18 Medicare coverage policies — 18 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
A55354Billing and Coding: Frequency of Hemodialysis
A55672Billing and Coding: Frequency of Hemodialysis
A55675Billing and Coding: Frequency of Hemodialysis

How I30.1 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 I30.1.

Pneumopyopericardium
Pyopericarditis, pyopericardium
Pyopneumopericardium
Abscess›pericardial
Pericarditis›bacterial(acute) (subacute) (with serous or seropurulent effusion)
Pericarditis›fibrinopurulent
Pericarditis›infective
Pericarditis›pneumococcal
Pericarditis›purulent
Pericarditis›septic
Pericarditis›staphylococcal
Pericarditis›streptococcal

Related codes at this level

Codes that share I30. If I30.1 is not quite right, the correct code is usually one of these.

Questions about I30.1

Is I30.1 a billable ICD-10-CM code?: Yes. I30.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does I30.1 sit in the tabular list?: Diseases of the circulatory system (I00-I99), in the block Other forms of heart disease (I30-I5A).