I31.3 — Pericardial effusion (noninflammatory)
I31.3 is a non-billable header ICD-10-CM code for pericardial effusion (noninflammatory). It cannot be billed on its own: choose one of the more specific child codes below.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- acute pericardial effusion (I30.9)
Excludes1 inherited from the categories above I31.3
These are not written on I31.3, but they bind it: a note on a category applies to every code beneath it. Billing I31.3 with anything listed here is a denial.
Other codes that can never be billed with I31.3
These codes carry an Excludes1 note pointing at I31.3. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading I31.3 alone.
Risk adjustment
I31.3 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.
Code history
I31.3 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Code to one of these instead I31.3
2 child codes. Green means billable.
Related codes at this level
Codes that share I31. If I31.3 is not quite right, the correct code is usually one of these.
Questions about I31.3
- Is I31.3 a billable ICD-10-CM code?
- No. I31.3 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does I31.3 sit in the tabular list?
- Diseases of the circulatory system (I00-I99), in the block Other forms of heart disease (I30-I5A).
- What cannot be coded together with I31.3?
- I31.3 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 I31.3 (I31) and apply to it just the same.