2025 ICD-10-CM code I01
(Active) Effective Date: N/A Revision Date: N/A Diseases of the circulatory system - Acute rheumatic fever IX Diseases of the circulatory system Feed
Rheumatic fever with heart involvement.
Modifiers may be applicable depending on the circumstances of the encounter and services provided.
Medical necessity is established by the presence of clinical symptoms and signs consistent with rheumatic fever and confirmed by diagnostic testing.Documentation should demonstrate the presence of carditis, supporting the need for specific management and treatment.This may include cardiac medications, monitoring, and potential need for surgical intervention in cases of severe valve damage.
Diagnosis and management of rheumatic fever and its cardiac complications. This includes assessment of symptoms, review of medical history and physical examination, electrocardiogram (ECG), echocardiogram, and laboratory tests to confirm the diagnosis and evaluate the extent of heart involvement. Treatment decisions include management of inflammation, antibiotic therapy (penicillin), and supportive measures to alleviate symptoms. For severe cases, referral to a cardiologist may be necessary for specialized management and follow-up care.
In simple words: This code means a person has rheumatic fever, which is a problem that can happen after a strep throat infection if it's not treated.This type of rheumatic fever affects the heart.
This code signifies rheumatic fever, a complication of untreated streptococcal infection, specifically involving the heart.It encompasses various cardiac manifestations, including pericarditis, endocarditis, and myocarditis.The diagnosis requires evidence of prior streptococcal infection and the presence of cardiac involvement.Further specification may be needed using more granular subcodes (e.g., I01.0, I01.1, I01.2) to indicate the specific part of the heart affected.
Example 1: A 10-year-old presents with fever, joint pain (polyarthritis), and a history of untreated strep throat.Echocardiogram reveals mitral valve regurgitation.Code I01 is assigned, potentially with a further specification such as I01.1 (acute rheumatic endocarditis) if endocarditis is confirmed., An adult patient with a history of rheumatic fever presents with worsening shortness of breath and chest pain.ECG shows signs of pericarditis. Code I01 would be appropriate, with a potential specification to I01.0 (acute rheumatic pericarditis)., A patient has a prior diagnosis of rheumatic heart disease, and a recent echocardiogram reveals worsening mitral valve stenosis. I01.9 (acute rheumatic heart disease, unspecified) may be used, as this doesn't require specific location.
Complete history and physical examination; evidence of preceding streptococcal infection (e.g., positive throat culture or rapid antigen detection test); echocardiogram to assess cardiac involvement; ECG findings consistent with rheumatic heart disease; relevant laboratory results (e.g., elevated inflammatory markers).
** This code is for acute rheumatic fever with cardiac involvement.Chronic rheumatic heart disease is coded separately (I05-I09).
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Specialties:Cardiology, Rheumatology, Pediatrics
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office