I52

I52: Other heart disorders in diseases classified elsewhere

Billable / specific codeICD-10-CM

I52 is a billable, specific ICD-10-CM code for other heart disorders in diseases classified elsewhere. It is valid for submission on a claim.

Check I52 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.

heart disease (in):
gonococcal infection (A54.83)
meningococcal infection (A39.50)
rheumatoid arthritis (M05.31)
syphilis (A52.06)

Code first

The underlying condition must be sequenced before this code.

underlying disease, such as:
congenital syphilis (A50.5)
mucopolysaccharidosis (E76.3)
schistosomiasis (B65.0-B65.9)

Risk adjustment

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

Medicare coverage

I52 is named in 9 Medicare coverage policies: 9 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A56625Billing and Coding: Echocardiography
A56781Billing and Coding: Transthoracic Echocardiography (TTE)
A56943Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment
A57037Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment

Code history

Unchanged in every release from FY2024 to FY2027.