2025 ICD-10-CM code I31.9
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Diseases of the circulatory system - Other diseases of pericardium Diseases of the circulatory system (I00-I99) Feed
Unspecified disease of the pericardium.
Medical necessity for coding I31.9 is established when a pericardial disease is suspected or confirmed, but the nature or specificity of the disease cannot be identified.This may be due to incomplete diagnostic information or the need for further clinical evaluations before a definitive diagnosis can be made.
The clinical responsibility for coding I31.9 lies with the physician or qualified healthcare professional who makes the diagnosis after a thorough examination and evaluation of the patient's medical history and current condition.
In simple words: This code is used when a person has a problem with the sac around their heart (the pericardium), but the exact nature of the problem is unknown or not specified by the doctor.
This code signifies a disease of the pericardium that is not specified or further defined.The pericardium is the sac-like membrane that surrounds the heart.Conditions included under this code may encompass various pericardial abnormalities, but without specific details.
Example 1: A patient presents with chest pain and discomfort.After an echocardiogram and other diagnostic tests, a pericardial effusion is detected but further specification of the cause (inflammatory or non-inflammatory) cannot be determined.I31.9 is assigned., A patient undergoes cardiac surgery, and post-operative evaluation reveals an abnormality of the pericardium, but the exact nature of the abnormality is unclear pending further investigation and/or testing. I31.9 is used temporarily until a definitive diagnosis is established., A patient with a history of heart disease presents with new symptoms suggestive of pericardial involvement.However, insufficient information is available from the initial examination and further tests are needed before the doctor can establish a specific diagnosis. I31.9 is applied temporarily for billing purposes.
Thorough documentation is crucial for accurate coding. This should include:
** This code is a placeholder for unspecified pericardial disease.It should be replaced with a more specific code once a proper diagnosis is determined.Always review the latest ICD-10-CM coding guidelines for the most updated information and potential changes.
- Payment Status: Active
- Specialties:Cardiology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office