I01 vs I05
I01 (Rheumatic fever with heart involvement) compared with I05 (Rheumatic mitral valve diseases), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.
Can these codes be reported together?
No — do not report together. I01 carries an Excludes1 note covering I05: “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.”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
Side by side
| I01Rheumatic fever with heart involvement | I05Rheumatic mitral valve diseases | |
|---|---|---|
| Billing status | Non-billable header | Non-billable header |
| Classification | I00-I99 — Diseases of the Circulatory System (I00-I99) | I00-I99 — Diseases of the Circulatory System (I00-I99) |
| Definition | Rheumatic fever with heart involvement is a non-billable ICD-10-CM category code (I01). | Rheumatic mitral valve diseases is a non-billable ICD-10-CM category code (I05). |
| Includes | — | conditions classifiable to both I05.0 and I05.2-I05.9, whether specified as rheumatic or not |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources