I31.4 — Cardiac tamponade
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
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
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).