I09.81

Rheumatic heart failure

Billable FY2026 2025-10-01 → 2026-09-30

Exclusions 10 never code together

I00-I99chapter

Excludes2

certain conditions originating in the perinatal period (P04-P96)P04-P96
certain infectious and parasitic diseases (A00-B99)A00-B99
complications of pregnancy, childbirth and the puerperium (O00-O9A)O00-O9A
congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)Q00-Q99
endocrine, nutritional and metabolic diseases (E00-E88)E00-E88
injury, poisoning and certain other consequences of external causes (S00-T88)S00-T88
neoplasms (C00-D49)C00-D49
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)R00-R94
systemic connective tissue disorders (M30-M36)M30-M36
transient cerebral ischemic attacks and related syndromes (G45.-)G45.-

Excludes2 — not included here, but the patient may have both. Code both when documented.

Instructional notes 1

I09.81code

Use additional code

code to identify type of heart failure (I50.-)I50.-

Index entries leading here 2

Failure, failed
- heart (acute) (senile) (sudden) I50.9
  - congestive I50.9
    - with rheumatic fever (conditions in I00)
      - inactive or quiescent (with chorea) I09.81
    - rheumatic (chronic) (inactive) (with chorea) I09.81
- ventricular I50.9
  - left I50.1
    - with rheumatic fever (conditions in I00)
      - inactive or quiescent (with chorea) I09.81
    - rheumatic (chronic) (inactive) (with chorea) I09.81
Fever (inanition) (of unknown origin) (persistent) (with chills) (with rigor) R50.9
- rheumatic (active) (acute) (chronic) (subacute) I00
  - inactive or quiescent with
    - heart failure (congestive) (conditions in category I50.) I09.81
    - left ventricular failure (conditions in I50.1-I50.4-) I09.81

Alongside this code 1 same parent — I09.8

I09.89 Other specified rheumatic heart diseases

Medications 3

246 Heart Failure drugs 4 Rheumatic Heart Disease drugs 1 Heart Failure, Systolic drugs

MED-RT files conditions by MeSH, which carves the world differently from ICD-10. These are name matches on this code's description, offered as candidates — not as an assertion that they are this code.

Additional references

AHA Coding Clinic® Licence required

Official coding advice for this code. Published by the American Hospital Association. Not included in this installation.

Risk adjustment

CMS22HCC85 CMS28HCC226 ESRD21HCC85 ESRD24HCC85 RX08HCC186

Presence is a property of the code. Untick a model to hide it everywhere.

This code

Billable: yes
Code set: FY2026
Parent: I09.8
Block: I05-I09
Siblings: 1

Present FY2024–FY2027.