2020 ICD-10-CM Diagnosis Code I09.81

Rheumatic heart failure

    2016 2017 2018 2019 2020 Billable/Specific Code
  • I09.81 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
  • The 2020 edition of ICD-10-CM I09.81 became effective on October 1, 2019.
  • This is the American ICD-10-CM version of I09.81 - other international versions of ICD-10 I09.81 may differ.
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Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. In most cases the manifestation codes will have in the code title, "in diseases classified elsewhere." Codes with this title are a component of the etiology/manifestation convention. The code title indicates that it is a manifestation code. "In diseases classified elsewhere" codes are never permitted to be used as first listed or principle diagnosis codes. They must be used in conjunction with an underlying condition code and they must be listed following the underlying condition.
  • code to identify type of heart failure (
    ICD-10-CM Diagnosis Code I50
    • I50 Heart failure
      • I50.1 Left ventricular failure, unspecified
      • I50.2 Systolic (congestive) heart failure
        • I50.20 Unspecified systolic (congestive) heart failu...
        • I50.21 Acute systolic (congestive) heart failure
        • I50.22 Chronic systolic (congestive) heart failure
        • I50.23 Acute on chronic systolic (congestive) heart ...
      • I50.3 Diastolic (congestive) heart failure
        • I50.30 Unspecified diastolic (congestive) heart fail...
        • I50.31 Acute diastolic (congestive) heart failure
        • I50.32 Chronic diastolic (congestive) heart failure
        • I50.33 Acute on chronic diastolic (congestive) heart...
      • I50.4 Combined systolic (congestive) and diastolic ...
        • I50.40 Unspecified combined systolic (congestive) an...
        • I50.41 Acute combined systolic (congestive) and dias...
        • I50.42 Chronic combined systolic (congestive) and di...
        • I50.43 Acute on chronic combined systolic (congestiv...
      • I50.8 Other heart failure
        • I50.81 Right heart failure
          • I50.810 …… unspecified
          • I50.811 Acute right heart failure
          • I50.812 Chronic right heart failure
          • I50.813 Acute on chronic right heart failure
          • I50.814 Right heart failure due to left heart failure...
        • I50.82 Biventricular heart failure
        • I50.83 High output heart failure
        • I50.84 End stage heart failure
        • I50.89 Other heart failure
      • I50.9 Heart failure, unspecified
    I50.-
    )
The following code(s) above I09.81 contain annotation back-references
Annotation Back-References
In this context, annotation back-references refer to codes that contain:
  • Applicable To annotations, or
  • Code Also annotations, or
  • Code First annotations, or
  • Excludes1 annotations, or
  • Excludes2 annotations, or
  • Includes annotations, or
  • Note annotations, or
  • Use Additional annotations
that may be applicable to I09.81:
  • I00-I99
    2020 ICD-10-CM Range I00-I99

    Diseases of the circulatory system

    Type 2 Excludes
    • certain conditions originating in the perinatal period (P04-P96)
    • certain infectious and parasitic diseases (A00-B99)
    • complications of pregnancy, childbirth and the puerperium (O00-O9A)
    • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
    • endocrine, nutritional and metabolic diseases (E00-E88)
    • injury, poisoning and certain other consequences of external causes (S00-T88)
    • neoplasms (C00-D49)
    • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
    • systemic connective tissue disorders (M30-M36)
    • transient cerebral ischemic attacks and related syndromes (G45.-)
    Diseases of the circulatory system
Approximate Synonyms
  • Congestive rheumatic heart failure
ICD-10-CM I09.81 is grouped within Diagnostic Related Group(s) (MS-DRG v37.0):
  • 222 Cardiac defibrillator implant with cardiac catheterization with ami/hf/shock with mcc
  • 223 Cardiac defibrillator implant with cardiac catheterization with ami/hf/shock without mcc
  • 291 Heart failure and shock with mcc
  • 292 Heart failure and shock with cc
  • 293 Heart failure and shock without cc/mcc
  • 791 Prematurity with major problems
  • 793 Full term neonate with major problems

Convert I09.81 to ICD-9-CM

Code History
  • 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM)
  • 2017 (effective 10/1/2016): No change
  • 2018 (effective 10/1/2017): No change
  • 2019 (effective 10/1/2018): No change
  • 2020 (effective 10/1/2019): No change
Code annotations containing back-references to I09.81:
  • Code First: I50
    ICD-10-CM Diagnosis Code I50

    Heart failure

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    Code First
    • heart failure complicating abortion or ectopic or molar pregnancy (O00-O07, O08.8)
    • heart failure due to hypertension (I11.0)
    • heart failure due to hypertension with chronic kidney disease (I13.-)
    • heart failure following surgery (I97.13-)
    • obstetric surgery and procedures (O75.4)
    • rheumatic heart failure (I09.81)
    Type 1 Excludes
    • neonatal cardiac failure (P29.0)
    Type 2 Excludes

Diagnosis Index entries containing back-references to I09.81:
  • Failure, failed
    • heart (acute) (senile) (sudden) I50.9
      ICD-10-CM Diagnosis Code I50.9

      Heart failure, unspecified

        2016 2017 2018 2019 2020 Billable/Specific Code
      Applicable To
      • Cardiac, heart or myocardial failure NOS
      • Congestive heart disease
      • Congestive heart failure NOS
      Type 2 Excludes
      • fluid overload unrelated to congestive heart failure (E87.70)
      • congestive I50.9
        ICD-10-CM Diagnosis Code I50.9

        Heart failure, unspecified

          2016 2017 2018 2019 2020 Billable/Specific Code
        Applicable To
        • Cardiac, heart or myocardial failure NOS
        • Congestive heart disease
        • Congestive heart failure NOS
        Type 2 Excludes
        • fluid overload unrelated to congestive heart failure (E87.70)
    • ventricular I50.9
      - see also Failure, heart
      ICD-10-CM Diagnosis Code I50.9

      Heart failure, unspecified

        2016 2017 2018 2019 2020 Billable/Specific Code
      Applicable To
      • Cardiac, heart or myocardial failure NOS
      • Congestive heart disease
      • Congestive heart failure NOS
      Type 2 Excludes
      • fluid overload unrelated to congestive heart failure (E87.70)
      • left I50.1
        - see also Failure, heart, left
        ICD-10-CM Diagnosis Code I50.1

        Left ventricular failure, unspecified

          2016 2017 2018 - Revised Code 2019 2020 Billable/Specific Code
        Applicable To
        • Cardiac asthma
        • Edema of lung with heart disease NOS
        • Edema of lung with heart failure
        • Left heart failure
        • Pulmonary edema with heart disease NOS
        • Pulmonary edema with heart failure
        Type 1 Excludes
        • edema of lung without heart disease or heart failure (J81.-)
        • pulmonary edema without heart disease or failure (J81.-)
  • Fever (inanition) (of unknown origin) (persistent) (with chills) (with rigor) R50.9
    ICD-10-CM Diagnosis Code R50.9

    Fever, unspecified

      2016 2017 2018 2019 2020 Billable/Specific Code
    Applicable To
    • Fever NOS
    • Fever of unknown origin [FUO]
    • Fever with chills
    • Fever with rigors
    • Hyperpyrexia NOS
    • Persistent fever
    • Pyrexia NOS
    • rheumatic (active) (acute) (chronic) (subacute) I00
      ICD-10-CM Diagnosis Code I00

      Rheumatic fever without heart involvement

        2016 2017 2018 2019 2020 Billable/Specific Code
      Includes
      • arthritis, rheumatic, acute or subacute
      Type 1 Excludes
      • rheumatic fever with heart involvement (I01.0 -I01.9)
      • inactive or quiescent with
        • heart failure I09.81 (congestive) (conditions in category I50.)
        • left ventricular failure I09.81 (conditions in I50.1- I50.4-)

ICD-10-CM Codes Adjacent To I09.81
I08.1 Rheumatic disorders of both mitral and tricuspid valves
I08.2 Rheumatic disorders of both aortic and tricuspid valves
I08.3 Combined rheumatic disorders of mitral, aortic and tricuspid valves
I08.8 Other rheumatic multiple valve diseases
I08.9 Rheumatic multiple valve disease, unspecified
I09 Other rheumatic heart diseases
I09.0 Rheumatic myocarditis
I09.1 Rheumatic diseases of endocardium, valve unspecified
I09.2 Chronic rheumatic pericarditis
I09.8 Other specified rheumatic heart diseases
I09.81 Rheumatic heart failure
I09.89 Other specified rheumatic heart diseases
I09.9 Rheumatic heart disease, unspecified
I10 Essential (primary) hypertension
I11 Hypertensive heart disease
I11.0 Hypertensive heart disease with heart failure
I11.9 Hypertensive heart disease without heart failure
I12 Hypertensive chronic kidney disease
I12.0 Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease
I12.9 Hypertensive chronic kidney disease with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
I13 Hypertensive heart and chronic kidney disease

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.