Is ICD-10-CM code I49 billable?

No, I49 (Other cardiac arrhythmias) 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 I49 belong to?

I49 belongs to Chapter 9 of the ICD-10-CM tabular list: I00–I99 (Diseases of the Circulatory System).

I49Not billable, use a more specific code below

Other cardiac arrhythmias

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

12 billable codes under I49: 2 are an MCC, 1 is a CC; 4 map to HCC 213 (Cardio-Respiratory Failure and Shock), HCC 238 (Specified Heart Arrhythmias).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

Excludes2: not included here, code separately if applicable

bradycardia NOS (R00.1)
neonatal dysrhythmia (P29.1-)
sinoatrial bradycardia (R00.1)
sinus bradycardia (R00.1)
vagal bradycardia (R00.1)

Code first: code the underlying condition first, then this code

cardiac arrhythmia complicating:
abortion or ectopic or molar pregnancy (O00-O07, O08.8)
obstetric surgery and procedures (O75.4)

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 I49

I49 can't be used on a claim. Pick a billable code below; grey headings group them.

I49 MS-DRGs

As the principal diagnosis, the billable codes under I49 group to MS-DRG 308, 309, 310, 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 308 Cardiac Arrhythmia and Conduction Disorders with MCC (12 of 12 codes)
DRG 309 Cardiac Arrhythmia and Conduction Disorders with CC (12 of 12 codes)
DRG 310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC (12 of 12 codes)
DRG 791 Prematurity with Major Problems (2 of 12 codes)
DRG 793 Full Term Neonate with Major Problems (2 of 12 codes)

Other codes that refer to I49

Notes on these codes point to I49.

M35.81 Code Also: cardiac arrhythmia (I47-I49.-)
R00 Excludes2: specified arrhythmias (I47-I49)

About the condition

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

Arrhythmia

An arrhythmia is a problem with the rate or rhythm of your heartbeat. Your heart beats too quickly, too slowly, or with an irregular pattern. Changes in the electrical signals that control your heartbeat cause arrhythmias.

Code history

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