2025 ICD-10-CM code I01.9
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Circulatory System - Acute rheumatic heart disease Diseases of the circulatory system (I00-I99) Feed
Acute rheumatic heart disease, unspecified; this code is used when there is acute rheumatic heart disease but the specific type of heart involvement is unknown.
Medical necessity for further investigation is established based on the presence of clinical symptoms and indicators strongly suggestive of acute rheumatic heart disease.Complete diagnostic workup is crucial to determine the extent of the disease and the specific heart structures involved, enabling targeted treatment and preventing serious complications.The absence of clear identification of the affected heart structure necessitates further tests.
The clinical responsibility lies with a cardiologist or other physician specializing in cardiovascular diseases to diagnose and manage acute rheumatic heart disease. This involves evaluating the patient's history, conducting a physical exam, ordering relevant diagnostic tests (e.g., echocardiography, electrocardiogram), and determining the appropriate treatment plan, which may include medication, supportive care, or referral to specialized services.If the acute rheumatic fever is a complication of a previous strep infection, managing that component is also important.
In simple words: This code means the patient has a sudden heart problem caused by rheumatic fever, but doctors don't yet know exactly which part of the heart is affected.
This ICD-10-CM code, I01.9, signifies acute rheumatic heart disease where the precise type of cardiac involvement (pericarditis, endocarditis, myocarditis) remains unspecified.It's applied when clinical findings indicate acute rheumatic heart disease, but further investigation is needed to determine the specific location of the inflammatory process within the heart. This code is distinct from chronic rheumatic heart conditions and excludes other conditions like congenital heart defects or those stemming from perinatal issues, infections, or other systemic diseases.
Example 1: A 10-year-old presents with fever, chest pain, and shortness of breath.Echocardiogram reveals valvular involvement, consistent with acute rheumatic heart disease, but further testing is necessary to pinpoint the precise location of the inflammation., A young adult with a history of untreated rheumatic fever experiences a sudden onset of heart palpitations and fatigue.Physical exam and initial labs indicate acute rheumatic heart disease, but the exact type of heart involvement is undetermined pending further testing., An adolescent with suspected acute rheumatic fever undergoes a comprehensive cardiac evaluation. Findings suggest acute rheumatic heart disease, however, the specific location of the inflammatory process remains unconfirmed, necessitating additional diagnostic workup.
Complete patient history detailing any previous streptococcal infections; physical examination findings; results of electrocardiogram (ECG) and echocardiogram; laboratory findings (e.g., inflammatory markers, antistreptolysin O titer); detailed documentation of symptoms and their onset; imaging results to determine the extent and location of the heart involvement, if any; and any treatment interventions.
** I01.9 is a nonspecific code and should be avoided if possible.Clinicians should strive to provide as much detail as possible to accurately represent the patient's condition.The diagnostic certainty indicators (A, G, V, or Z) should be appended to this code in outpatient settings to indicate the level of diagnostic confidence.
- Payment Status: Active
- Specialties:Cardiology, Rheumatology, Internal Medicine, Pediatric Cardiology
- Place of Service:Office, Hospital Inpatient, Hospital Outpatient, Emergency Room - Hospital