I31.31 — Malignant pericardial effusion in diseases classified elsewhere
I31.31 is a billable, specific ICD-10-CM code for malignant pericardial effusion in diseases classified elsewhere. It is valid for submission on a claim.
Other codes that can never be billed with I31.31
These codes carry an Excludes1 note pointing at I31.31. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading I31.31 alone.
- I31.2Hemopericardium, not elsewhere classified
Risk adjustment
I31.31 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 17 Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic4.209 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
I31.31 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
- A56451Billing and Coding: Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA)
- A56500Billing and Coding: Cardiac Catheterization and Coronary Angiography
How I31.31 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 I31.31.
- Effusion›pericardium, pericardial›malignant, in disease classified elsewhere
Related codes at this level
Codes that share I31.3. If I31.31 is not quite right, the correct code is usually one of these.
Questions about I31.31
- Is I31.31 a billable ICD-10-CM code?
- Yes. I31.31 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does I31.31 sit in the tabular list?
- Diseases of the circulatory system (I00-I99), in the block Other forms of heart disease (I30-I5A).