I38 — Endocarditis, valve unspecified
I38 is a billable, specific ICD-10-CM code for endocarditis, valve unspecified. It is valid for submission on a claim.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Includes
Conditions this code covers.
- endocarditis (chronic) NOS
- valvular incompetence NOS
- valvular insufficiency NOS
- valvular regurgitation NOS
- valvular stenosis NOS
- valvulitis (chronic) NOS
Other codes that can never be billed with I38
These codes carry an Excludes1 note pointing at I38. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading I38 alone.
Risk adjustment
I38 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
I38 is named in 18 Medicare coverage policies — 18 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
- A52868Billing and Coding: Transesophageal Echocardiography (TEE)
- A56476Billing and Coding: Cardiac Radionuclide Imaging
How I38 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 I38.
- Endocarditis(chronic) (marantic) (nonbacterial) (thrombotic) (valvular)
- Disease, diseased›valve, valvular
- Endocarditis›arteriosclerotic
- Insufficiency, insufficient›valve, valvular(heart)
- Stenosis, stenotic›heart valve
- Stenosis, stenotic›valve(cardiac) (heart)
- Hypertrophy, hypertrophic›heart›valve
- Stricture›heart›valve
Questions about I38
- Is I38 a billable ICD-10-CM code?
- Yes. I38 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does I38 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 I38?
- I38 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.