Is ICD-10-CM code I05 billable?

No, I05 (Rheumatic mitral valve diseases) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code I05 belong to?

I05 belongs to Chapter 9 of the ICD-10-CM tabular list: I00–I99 (Diseases of the Circulatory System).

I05Not billable, use a more specific code below

Rheumatic mitral valve diseases

In Chronic rheumatic heart diseases (I05-I09), chapter 9: Diseases of the Circulatory System

5 billable codes under I05: none are a CC or MCC; none map to an HCC.

Instructional notes

Includes: conditions that are coded here

conditions classifiable to both I05.0 and I05.2-I05.9, whether specified as rheumatic or not

Excludes1: not coded here, use a different code

mitral valve disease specified as nonrheumatic (I34.-)
mitral valve disease with aortic and/or tricuspid valve involvement (I08.-)

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

Covers hypertension with heart and kidney disease, coronary artery disease with angina, perioperative stroke, cerebrovascular sequelae, and acute myocardial infarction types and timing.

Hypertension (page 50)
Atherosclerotic Coronary Artery Disease and Angina (page 52)
Intraoperative and Postprocedural Cerebrovascular Accident (page 53)
Sequelae of Cerebrovascular Disease (page 53)
Acute myocardial infarction (AMI) (page 54)

Read Section I.C.9 (page 50)

All codes under I05

I05 can't be used on a claim. Pick a billable code below; grey headings group them.

I05 MS-DRGs

As the principal diagnosis, all 5 billable codes under I05 group to MS-DRG 306 or 307 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

Other codes that refer to I05

Notes on these codes point to I05.

I01 Excludes1: chronic diseases of rheumatic origin (I05-I09) unless rheumatic fever is also present or there is evidence of reactivation or activity of the rheumatic process.
I27.22 Code Also: rheumatic mitral valve diseases (I05.-)
I34 Excludes1: mitral valve disorder specified as rheumatic (I05.-)

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

Heart Valve Diseases

Heart valve disease happens when one or more of your heart valves don't work well. Your heart has four valves: the tricuspid, pulmonary, mitral, and aortic valves. The valves have flaps that open and close. The flaps make sure that blood flows in the right direction through your heart and to the rest of your body. When your heart beats, the flaps open to let blood through. Between heartbeats they close to stop the blood from flowing backwards.

Streptococcal Infections

Strep is short for Streptococcus, a type of bacteria that often lives in your nose and throat. Most strep infections are mild, but some may become serious depending on your overall health.

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.