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2025 ICD-10-CM code I31

Other diseases of the pericardium, excluding specific conditions like rheumatic pericarditis, post-cardiotomy syndrome, or traumatic injury.

This code should only be used when a more specific diagnosis cannot be established.Clinicians must carefully consider the differential diagnosis for pericardial diseases to accurately select the most precise code.

Modifiers may be applicable depending on the specific procedure or service performed and the circumstances of the encounter. Consult current coding guidelines for specific modifier application.

Medical necessity is determined based on the clinical presentation, severity of symptoms, and the impact on cardiac function.Further investigations are often necessary to justify this code's use.

Cardiologist, Cardiac surgeon

IMPORTANT:Specific types of pericardial disease (e.g., I30 for acute pericarditis, I31.1 for chronic constrictive pericarditis, I31.3 for pericardial effusion) should be used when applicable.This code is for nonspecific or unspecified pericardial disorders.

In simple words: This code covers various heart sac (pericardium) problems that aren't specifically listed elsewhere.These problems could include inflammation, scarring, fluid buildup, or other issues with the sac surrounding the heart.

This ICD-10-CM code encompasses a range of pericardial disorders not otherwise specified, such as chronic adhesive pericarditis, chronic constrictive pericarditis, hemopericardium (not elsewhere classified), pericardial effusion (noninflammatory), and other specified diseases of the pericardium.It excludes conditions explicitly categorized elsewhere, including rheumatic pericarditis, post-cardiotomy syndrome, and traumatic pericardial injuries.

Example 1: A 65-year-old patient presents with chest pain and shortness of breath.Echocardiography reveals pericardial thickening and restriction of heart movement, consistent with chronic constrictive pericarditis (I31.1)., A 40-year-old patient undergoes cardiac surgery. Post-operatively, there is evidence of excessive pericardial fluid accumulation (pericardial effusion), but it's deemed non-inflammatory (I31.3)., A 70-year-old patient with a history of tuberculosis presents with cardiac symptoms.Imaging reveals pericardial adhesions and scarring (I31.8), likely related to previous infection.

Detailed history and physical examination, echocardiogram, cardiac catheterization (if indicated), and any relevant imaging studies (CT, MRI).

** Always refer to the latest official ICD-10-CM coding guidelines for the most up-to-date information and clarification on this code's usage.This information is current as of December 3rd, 2024.

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