I51.0

I51.0: Cardiac septal defect, acquired

Billable / specific codeICD-10-CM

I51.0 is a billable, specific ICD-10-CM code for cardiac septal defect, acquired. It is valid for submission on a claim.

Check I51.0 with the rest of the claim: free scrubber

Excludes1: never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

cardiac septal defect as current complication following acute myocardial infarction (I23.1, I23.2)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Acquired septal atrial defect (old)
Acquired septal auricular defect (old)
Acquired septal ventricular defect (old)

Excludes2 inherited from the categories above I51.0

Not part of this code, but both may be coded when both are present.

Written on I51: Complications and ill-defined descriptions of heart disease

heart disease specified as rheumatic (I00-I09)

Other codes that can never be billed with I51.0

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

I23.1Atrial septal defect as current complication following acute myocardial infarction
I23.2Ventricular septal defect as current complication following acute myocardial infarction
Q21Congenital malformations of cardiac septa

Risk adjustment

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

Medicare coverage

I51.0 is named in 12 Medicare coverage policies: 12 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)
A56476Billing and Coding: Cardiac Radionuclide Imaging
A56500Billing and Coding: Cardiac Catheterization and Coronary Angiography

Alphabetic index entries that lead here

Defect, defective›septal NOS›acquired(atrial) (auricular) (ventricular) (old)

Code history

Unchanged in every release from FY2024 to FY2027.