Is ICD-10-CM code I31 billable?

No, I31 (Other diseases of pericardium) 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 I31 belong to?

I31 belongs to Chapter 9 of the ICD-10-CM tabular list: I00–I99 (Diseases of the Circulatory System).

I31Not billable, use a more specific code below

Other diseases of pericardium

In Other forms of heart disease (I30-I5A), chapter 9: Diseases of the Circulatory System

8 billable codes under I31: all are a CC; 1 map to HCC 17 (Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic).A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment. An HCC counts toward a Medicare Advantage patient's risk score.

Instructional notes

Excludes1: not coded here, use a different code

diseases of pericardium specified as rheumatic (I09.2)
postcardiotomy syndrome (I97.0)
traumatic injury to pericardium (S26.-)

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 I31

I31 can't be used on a claim. Pick a billable code below; grey headings group them.

I31 MS-DRGs

As the principal diagnosis, the billable codes under I31 group to MS-DRG 314, 315, 316, 791, or 793 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 314 Other Circulatory System Diagnoses with MCC (8 of 8 codes)
DRG 315 Other Circulatory System Diagnoses with CC (8 of 8 codes)
DRG 316 Other Circulatory System Diagnoses without CC/MCC (8 of 8 codes)
DRG 791 Prematurity with Major Problems (1 of 8 codes)
DRG 793 Full Term Neonate with Major Problems (1 of 8 codes)

Other codes that refer to I31

Notes on these codes point to I31.

I09.2 Excludes1: chronic pericarditis not specified as rheumatic (I31.-)

About the condition

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

Pericardial Disorders

The pericardium is a membrane, or sac, that surrounds your heart. It holds the heart in place and helps it work properly. Problems with the pericardium include:

Code history

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