Skip to main content

I01 ICD-10-CM Code: Rheumatic fever with heart involvement

Compare with another code for I01Check this code on a claim

Billing Status: NO. This is a non-billable ICD-10-CM code: report a more specific billable code beneath it.

Coding at a Glance

Tabular directives
1 Excludes1

Category · FY2027A non-billable heading in the tabular list: report a more specific code beneath it.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too, and is marked with where it comes from.

Excludes1Not reported with this code unless documented as unrelated
  • 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.

Where it sits Source: CMS/NCHS

Under:Chapter 9: Diseases of the Circulatory SystemI00-I02 Acute rheumatic fever

Codes under I01 (5)

  • I01.0Acute rheumatic pericarditisBillable
  • I01.1Acute rheumatic endocarditisBillable
  • I01.2Acute rheumatic myocarditisBillable
  • I01.8Other acute rheumatic heart diseaseBillable
  • I01.9Acute rheumatic heart disease, unspecifiedBillable

CompareCheck ClaimView Related Codes

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for I01 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

  • 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. Compare I01 vs I05 →

Coder workflow for I01

MedCoder structured workflow — derived from this code’s own official record

Before you code I01

  1. I01 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

    ReviewI01.0, I01.1, I01.2, I01.8, I01.9

    See the relationships section · Guide: How to choose an ICD-10-CM code →

  2. I01’s title joins a condition with an associated condition or complication. Confirm each component is documented. Where the classification presumes the link through the “with” convention, only a provider statement that the conditions are unrelated defeats it. A combination code is assigned only when it fully identifies the documented conditions; a required second code for the stage, type or manifestation is still reported when the notes ask for it (Guidelines I.B.9, I.A.15).

    Guide: Combination codes →

  3. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with the code beneath I01. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support one of the more specific codes beneath I01?
    Yes → Select that code and continue the checks below on its own page.
    No → I01 cannot be reported as written. Where the codes beneath it include an unspecified code, that code applies when the record goes no further; otherwise query for the missing detail.

    ReviewI01.0, I01.1, I01.2, I01.8, I01.9

  2. Does the documentation support a condition named in I01’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

Report the code beneath I01 that the documentation supports, not I01 itself. Then confirm that code is valid for the date of service on its own page.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
The associated condition or complication
Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).

Official instructions as workflow

  • Excludes1 — check before selecting I01(1 note)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with I01: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    See the official tabular notes · Guidelines I.A.12.a

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition I01 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

Documentation: Only one of the components this code’s title joins is documented.

Coding question: Is the code beneath I01 supported?

Path: Review the code for the documented component on its own.

Reason: A combination code is assigned only when it fully identifies the documented conditions; otherwise the documented component takes its own code (Guidelines I.B.9).

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse I01 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of I01 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • I05— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of chronic diseases of rheumatic origin unless rheumatic fever is also present or there is evidence of reactivation or activity of the rheumatic process. moves the case to I05; the two are not reported together unless documented as unrelated.

    Full comparison: I01 vs I05 →

  • I09— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of chronic diseases of rheumatic origin unless rheumatic fever is also present or there is evidence of reactivation or activity of the rheumatic process. moves the case to I09; the two are not reported together unless documented as unrelated.

    Full comparison: I01 vs I09 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Rheumatic fever with heart involvement is a non-billable ICD-10-CM category code (I01). A more specific billable subcode must be selected for claims submission.

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Verify Before Coding

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name I01 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Excludes2 note: I51 — Complications and ill-defined descriptions of heart disease.

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Related Codes

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Fever”; these codes share that main term but sit in a different category of the Tabular List.

B52.9 — Plasmodium malariae malaria without complication (quartan), B53.0 — Plasmodium ovale malaria (Plasmodium ovale), B55.0 — Visceral leishmaniasis (Assam), B65.2 — Schistosomiasis due to Schistosoma japonicum (Katayama), B83.9 — Helminthiasis, unspecified (worm), B99.8 — Other infectious disease (infective, specified NEC), B99.9 — Unspecified infectious disease (infective), D70.9 — Neutropenia, unspecified (neutropenic), D86.89 — Sarcoidosis of other sites (uveoparotid), I00 — Rheumatic fever without heart involvement (rheumatic), I02.9 — Rheumatic chorea without heart involvement (rheumatic, with central nervous system involvement), I05.9 — Rheumatic mitral valve disease, unspecified (rheumatic, inactive or quiescent with, endocarditis, mitral), I06.9 — Rheumatic aortic valve disease, unspecified (rheumatic, inactive or quiescent with, endocarditis, aortic), I07.8 — Other rheumatic tricuspid valve diseases (rheumatic, inactive or quiescent with, endocarditis, tricuspid), I08.0 — Rheumatic disorders of both mitral and aortic valves (rheumatic, inactive or quiescent with, endocarditis, aortic, with mitraldisease), I09.0 — Rheumatic myocarditis (rheumatic, inactive or quiescent with, myocarditis, myocardial degeneration), I09.1 — Rheumatic diseases of endocardium, valve unspecified (rheumatic, inactive or quiescent with, endocarditis), I09.2 — Chronic rheumatic pericarditis (rheumatic, inactive or quiescent with, pericarditis), I09.81 — Rheumatic heart failure (rheumatic, inactive or quiescent with, heart failure), I09.89 — Other specified rheumatic heart diseases (rheumatic, inactive or quiescent with, heart disease NEC), +109 more

Contextual Map

Every relationship of I01 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run I01 with these 6 related codes in Claim Check

Hierarchy

Excludes1

  • I05 — Rheumatic mitral valve diseases[Excludes1]: “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.”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
  • I06 — Rheumatic aortic valve diseases[Excludes1]: “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.”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
  • I07 — Rheumatic tricuspid valve diseases[Excludes1]: “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.”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
  • I08 — Multiple valve diseases[Excludes1]: “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.”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
  • I09 — Other rheumatic heart diseases[Excludes1]: “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.”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027

Referenced by Excludes2 notes

Index entries

  • Fever (inanition) (of unknown origin) (persistent) (with chills) (with rigor), rheumatic (active) (acute) (chronic) (subacute), active with heart involvement[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027

Nearest codes

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Indexed Clinical Terms (1)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Common coding questions

MedCoder editorial

Can I01 be billed directly?

No. I01 (Rheumatic fever with heart involvement) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder-derived relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder editorial explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "I01 — Rheumatic fever with heart involvement." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/i01-rheumatic-fever-with-heart-involvement

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Rheumatic fever with heart involvement

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to I01 in its code family, with their registry titles.