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.
Check I31.31 with the rest of the claim: free scrubberExcludes1 inherited from the categories above I31.31
A category’s note binds every code beneath it.
Other codes that can never be billed with I31.31
Their own Excludes1 notes name this code, so the conflict is not listed above.
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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
I31.31 is named in 14 Medicare coverage policies: 14 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- 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
- A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
Alphabetic index entries that lead here
- Effusion›pericardium, pericardial›malignant, in disease classified elsewhere
Code history
Unchanged in every release from FY2024 to FY2027.