Endocarditis, valve unspecified
In Other forms of heart disease (I30-I5A), chapter 9: Diseases of the Circulatory System
- I38 is an unspecified code: use it only when the record doesn't document anything more specific. If the record has more detail, check the other codes under I30-I5A below.
- As a secondary diagnosis it is a CC (complication or comorbidity), which can raise the MS-DRG payment. It doesn't count when the principal diagnosis is one of 8 closely related codes.
- Doesn't count toward a Medicare Advantage risk score (no HCC in V28).
- AHRQ's Chronic Condition Indicator classes it as chronic: expected to last 12 months or longer and to limit daily life or need ongoing care.
- 5,099 US deaths in 2024 had an underlying cause in category I38, per the National Vital Statistics System on CDC WONDER. Death records use WHO ICD-10, so the count is for the whole category.
Also indexed as: Disease, valve, valvular; Endocarditis; Endocarditis, arteriosclerotic; Hypertrophy, heart, valve; Insufficiency, valve, valvular; Stenosis, heart valve; Stenosis, valve; Stricture, heart, valve
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Instructional notes
Includes: conditions that are coded here
- endocarditis (chronic) NOS
- valvular incompetence NOS
- valvular insufficiency NOS
- valvular regurgitation NOS
- valvular stenosis NOS
- valvulitis (chronic) NOS
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)
Other codes under I30-I5A
Other forms of heart disease (I30-I5A)
- I30Acute pericarditis
- I31Other diseases of pericardium
- I32Pericarditis in diseases classified elsewhere
- I33Acute and subacute endocarditis
- I34Nonrheumatic mitral valve disorders
- I35Nonrheumatic aortic valve disorders
- I36Nonrheumatic tricuspid valve disorders
- I37Nonrheumatic pulmonary valve disorders
- I38Endocarditis, valve unspecified(this code)
- I39Endocarditis and heart valve disorders in diseases classified elsewhere
- I40Acute myocarditis
- I41Myocarditis in diseases classified elsewhere
- I42Cardiomyopathy
- I43Cardiomyopathy in diseases classified elsewhere
- I44Atrioventricular and left bundle-branch block
- I45Other conduction disorders
- I46Cardiac arrest
- I47Paroxysmal tachycardia
- I48Atrial fibrillation and flutter
- I49Other cardiac arrhythmias
- I50Heart failure
- I51Complications and ill-defined descriptions of heart disease
- I52Other heart disorders in diseases classified elsewhere
- I5ANon-ischemic myocardial injury (non-traumatic)
I38 MS-DRGs
As the principal diagnosis, I38 groups to MS-DRG 306, 307, 791, or 793 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.
Related conditions
Grouped by AHRQ's Clinical Classifications Software Refined (CCSR), which sorts every diagnosis code into clinically meaningful categories.
I38 is in Endocarditis and endocardial disease (CIR004, its default category), with 18 codes. Others in it:
Medicare coverage articles listing I38
These 8 Medicare billing and coding articles list I38 as a diagnosis that supports medical necessity for the services they cover. From the CMS Medicare Coverage Database; check your own contractor's article before billing.
- Transesophageal Echocardiography (TEE) (3 contractors)
- Cardiac Catheterization and Coronary Angiography (2 contractors)
- Transthoracic Echocardiography (TTE) (2 contractors)
- Artificial Hearts and Percutaneous Endovascular Cardiac Assist Procedures and Devices
- Cardiac Radionuclide Imaging
- Echocardiography
- Monitored Anesthesia Care
- Transesophageal Echocardiogram
Other codes that refer to I38
Notes on these codes point to I38.
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
Endocarditis
Endocarditis is sometimes called infective endocarditis. It's a rare but life-threatening inflammation of the lining inside your heart's chambers and valves (the endocardium).
Read more about endocarditis on MedlinePlusHeart 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.
Read more about heart valve diseases on MedlinePlusCode history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.
ICD-9-CM equivalent
Legacy crosswalk from the CMS General Equivalence Mappings (last updated 2018).
- 424.90 Endocarditis, valve unspecified, unspecified cause (approximate)
- 424.99 Other endocarditis, valve unspecified (approximate)