Is I31.4 a billable ICD-10-CM code?

Yes. I31.4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does I31.4 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 I31.4?

I31.4 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 I31.4 (I31) and apply to it just the same.

I31.4

I31.4 — Cardiac tamponade

Billable / specific codeICD-10-CM

I31.4 is a billable, specific ICD-10-CM code for cardiac tamponade. It is valid for submission on a claim.

Code first

The underlying condition must be sequenced before this code.

underlying cause

Excludes1 inherited from the categories above I31.4

These are not written on I31.4, but they bind it: a note on a category applies to every code beneath it. Billing I31.4 with anything listed here is a denial.

Written on I31 — Other diseases of pericardium

diseases of pericardium specified as rheumatic (I09.2)
postcardiotomy syndrome (I97.0)
traumatic injury to pericardium (S26.-)

Other codes that can never be billed with I31.4

These codes carry an Excludes1 note pointing at I31.4. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading I31.4 alone.

I09.2Chronic rheumatic pericarditis

Risk adjustment

I31.4 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

I31.4 is named in 16 Medicare coverage policies — 16 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
A52868Billing and Coding: Transesophageal Echocardiography (TEE)
A56451Billing and Coding: Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA)
A56500Billing and Coding: Cardiac Catheterization and Coronary Angiography

How I31.4 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 I31.4.

Tamponade, heart
Cardiac›tamponade

Code history

I31.4 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share I31. If I31.4 is not quite right, the correct code is usually one of these.

Questions about I31.4

Is I31.4 a billable ICD-10-CM code?: Yes. I31.4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does I31.4 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 I31.4?: I31.4 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 I31.4 (I31) and apply to it just the same.