2025 ICD-10-CM code I01.8
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Diseases of the circulatory system - Acute rheumatic fever Diseases of the circulatory system (I00-I99) Feed
Other acute rheumatic heart disease; any condition in I00 with other or multiple types of heart involvement.
Modifiers may be applicable depending on the circumstances of the encounter and the services rendered.
Medical necessity is established through documentation of symptoms consistent with acute rheumatic fever, such as fever, carditis (inflammation of the heart), polyarthritis (joint inflammation), and chorea (involuntary movements).Laboratory evidence supporting the diagnosis (e.g., elevated inflammatory markers, positive streptococcal antibody titres) is crucial for medical necessity.
The clinical responsibility rests with a cardiologist or physician specializing in rheumatic diseases.They would perform a comprehensive examination, review medical history and any prior tests, and order further investigations to confirm the diagnosis and assess the extent of heart involvement.
In simple words: This code describes various types of acute heart problems caused by rheumatic fever, which is an inflammation triggered by a strep throat infection.It covers situations where the heart is affected in more than one way or the specific type of heart involvement isn't precisely known.
This code classifies other acute rheumatic heart diseases, encompassing any condition listed under I00 (Acute rheumatic fever) with unspecified or multiple types of heart involvement.It includes acute rheumatic pancarditis and other presentations not specifically categorized elsewhere within the I01 codes.It excludes chronic rheumatic heart diseases (I05-I09) unless active rheumatic fever is concurrently present or there is evidence of reactivation or ongoing rheumatic process.
Example 1: A 10-year-old patient presents with fever, joint pain, and shortness of breath following a streptococcal infection.Echocardiography reveals inflammation of the pericardium, myocardium, and endocardium.Code I01.8 is appropriate as it reflects multiple forms of cardiac involvement., An adult patient with a history of rheumatic fever experiences recurrent chest pain and palpitations. Physical examination is unremarkable, but cardiac biomarkers are elevated.Further investigations including echocardiography are necessary to determine the type of acute heart involvement.Until specific details are obtained, I01.8 is used., A young adult with a history of untreated streptococcal pharyngitis is admitted with symptoms suggestive of acute rheumatic fever. Initial echocardiogram shows mild mitral valve insufficiency but no other significant findings.Due to the unclear extent of involvement, I01.8 is applied, pending further evaluation.
Complete medical history including past infections, physical examination findings (including cardiac auscultation), echocardiogram results, electrocardiogram (ECG) findings, inflammatory markers (e.g., ESR, CRP), and other relevant investigations to support the diagnosis and the extent of heart involvement.
** This code should be used cautiously and only when the specific type of acute rheumatic heart disease cannot be definitively identified.Further investigations are generally needed to clarify the diagnosis and ensure appropriate management.
- Payment Status: Active
- Specialties:Cardiology, Rheumatology, Pediatric Cardiology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Physician's Office