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2025 ICD-10-CM code I30.1

Infective pericarditis encompasses various types of pericarditis caused by infectious agents.

Always code to the highest level of specificity.Use additional codes to identify the causative organism (B95-B97) and to specify any complications.

Medical necessity for coding I30.1 is established when there is clinical evidence supporting the diagnosis of infective pericarditis. This evidence should include diagnostic testing confirming the presence of infection and pericardial inflammation. Treatment decisions and the medical necessity for interventions will depend on the severity of the illness and the patient's overall condition.

Diagnosis and management of infective pericarditis requires a thorough clinical evaluation, including history taking, physical examination, and diagnostic testing (e.g., electrocardiogram (ECG), echocardiogram, chest x-ray, blood cultures). Treatment may involve antibiotics (for bacterial infections), antiviral medications (for viral infections), or other appropriate therapies depending on the identified pathogen and the severity of the infection.In severe cases, pericardiocentesis (removal of fluid from the pericardium) or surgery may be necessary.

IMPORTANT:Consider additional codes (B95-B97) to specify the infectious agent.Related codes include I30.0 (Acute nonspecific idiopathic pericarditis), I30.8 (Other forms of acute pericarditis), and I30.9 (Acute pericarditis, unspecified).

In simple words: Infective pericarditis is an infection of the sac surrounding the heart.This infection can be caused by bacteria, viruses, or fungi and may cause chest pain and fever.

Infective pericarditis (I30.1) is an inflammation of the pericardium (the sac surrounding the heart) caused by an infection.This can be caused by a wide range of pathogens including bacteria (e.g., pneumococcal, staphylococcal, streptococcal), viruses, and fungi.The condition may present acutely or subacutely, and the severity can vary widely.Clinical manifestations include chest pain, fever, and pericardial effusion (fluid accumulation around the heart).

Example 1: A 65-year-old male presents with acute-onset chest pain, fever, and shortness of breath.Echocardiography reveals a large pericardial effusion. Blood cultures are positive for Staphylococcus aureus.A diagnosis of infective pericarditis is made, and the patient is treated with intravenous antibiotics and pericardiocentesis., A 30-year-old female with a history of systemic lupus erythematosus develops pericarditis.Echocardiogram shows mild pericardial effusion.Blood cultures are negative.A diagnosis of infective pericarditis is suspected, and the patient undergoes empirical antibiotic treatment. Further investigations are needed to pinpoint the exact causative pathogen., A 70-year-old patient with a history of chronic kidney disease develops symptoms consistent with pericarditis.Echocardiogram confirms pericardial effusion.The patient receives antibiotics and diuretics, with close monitoring of renal function.

Detailed medical history including symptoms (e.g., chest pain, shortness of breath, fever), physical examination findings, ECG, echocardiogram results, chest x-ray findings, laboratory results (including complete blood count, inflammatory markers, blood cultures), and details of any interventions (e.g., pericardiocentesis, surgery) and response to treatment.

** This code should be used for cases of pericarditis where the infection is confirmed or strongly suspected.For cases where the cause of pericarditis is unclear, consider I30.0 (Acute nonspecific idiopathic pericarditis) or I30.9 (Acute pericarditis, unspecified).

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