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.

Check I31.4 with the rest of the claim: free scrubber

Code first

The underlying condition must be sequenced before this code.

underlying cause

Excludes1 inherited from the categories above I31.4

A category’s note binds every code beneath it.

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

Their own Excludes1 notes name this code, so the conflict is not listed above.

I09.2Chronic rheumatic pericarditis

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

I31.4 is named in 13 Medicare coverage policies: 13 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

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