2025 ICD-10-CM code I09.9
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Chronic rheumatic heart diseases - Other rheumatic heart diseases Diseases of the circulatory system (I00-I99) Feed
Rheumatic heart disease, unspecified.
Modifiers are not applicable to ICD-10 codes.
Medical necessity for coding I09.9 would be established by documentation supporting the diagnosis of rheumatic heart disease, regardless of the unspecified nature of the valvular or cardiac involvement.This would typically involve evidence of prior rheumatic fever and current clinical manifestations.
The clinical responsibility for this code lies with the cardiologist or physician managing the patient's cardiovascular health.They would be responsible for diagnosis, treatment, and ongoing management of the rheumatic heart disease.
In simple words: This code is used when a person has a heart problem caused by rheumatic fever, but the doctor doesn't have enough information to specify the exact type of heart problem.
This ICD-10-CM code classifies rheumatic heart disease when the specific type of rheumatic heart disease cannot be specified.It encompasses any chronic rheumatic heart condition not otherwise specified by more specific I05-I09 codes. This includes conditions affecting the myocardium, endocardium, valves, and pericardium, resulting from previous rheumatic fever.
Example 1: A 60-year-old patient presents with shortness of breath and fatigue.Echocardiogram reveals mitral valve regurgitation consistent with a history of rheumatic fever in childhood.The physician documents chronic rheumatic heart disease with unspecified valvular involvement, coding I09.9., A 45-year-old patient with a known history of rheumatic fever is admitted for worsening heart failure.Cardiac catheterization shows mild mitral stenosis and moderate aortic regurgitation.Due to the multiple valvular involvements, I09.9 is used in the absence of more precise specifications., A 25-year-old patient with a previous diagnosis of rheumatic fever is seen for routine follow-up.The patient has no current symptoms, and echocardiogram reveals minimal valvular changes.While minimal changes exist, the exact nature of the residual rheumatic heart disease is uncertain, leading to the use of I09.9.
Comprehensive medical history, including details on prior rheumatic fever episodes; physical examination findings focusing on cardiovascular system; echocardiogram reports detailing valvular function and cardiac structure; and any relevant laboratory tests (e.g., cardiac biomarkers).
** This code is for use when a definitive diagnosis of rheumatic heart disease is made, but the exact nature and extent of the cardiac involvement are not fully specified or documented.This code is not intended for use in the absence of a confirmed diagnosis of rheumatic heart disease.
- Revenue Code: Revenue codes will vary depending on the specific services provided and the payer.
- RVU: RVUs are not directly associated with ICD-10 codes.Reimbursement is determined by the procedures and services provided, which would utilize CPT codes, and then RVUs would be applied to those codes according to the payer's fee schedule.
- Global Days: Not applicable to ICD-10 codes.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Fee Schedule: Not applicable to ICD-10 codes.
- Specialties:Cardiology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office