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I09.89 ICD-10-CM Code: Other specified rheumatic heart diseases

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
1 inclusion term

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 306 — CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC (MDC 05)
  • MS-DRG 307 — CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC (MDC 05)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for I09.89 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

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Rheumatic disease of pulmonary valve

Coder workflow for I09.89

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

Before you code I09.89

  1. “Other” (NEC) means the condition is specified in the record but no dedicated code captures it. Confirm the documented form is not one a sibling code names before settling on I09.89; if the record states no specifics at all, the unspecified sibling applies instead. “Other” codes are for documented conditions the classification gives no specific code; “unspecified” codes are for records lacking the detail (Guidelines I.A.9.a, I.A.9.b).

    ReviewI09.81

    See the relationships section · Guide: Other vs unspecified (NEC vs NOS) →

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).
Any detail beyond this code’s title
What the record states that a more specific sibling code would capture — or its absence, which itself supports the unspecified code.

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.

Code Overview

Other specified rheumatic heart diseases is a billable ICD-10-CM diagnosis code (I09.89).

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

Indexed Clinical Terms (15)

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.

Verify Before Coding

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

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 structured relationships — computed from published CMS and AHRQ datasets

Other codes that name I09.89 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 2 Excludes1 notes: I01 — Rheumatic fever with heart involvement (via I09.-), I37 — Nonrheumatic pulmonary valve disorders.

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 1 Excludes2 note: I51 — Complications and ill-defined descriptions of heart disease (via I09.-).

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

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 2 MS-DRGs: DRG 306 (MDC 05), DRG 307 (MDC 05).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):CIR001 — Chronic rheumatic heart disease (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Chronic rheumatic heart disease).

I06.1 — Rheumatic aortic insufficiency, I06.2 — Rheumatic aortic stenosis with insufficiency, I06.8 — Other rheumatic aortic valve diseases, I06.9 — Rheumatic aortic valve disease, unspecified, I07.0 — Rheumatic tricuspid stenosis, I07.1 — Rheumatic tricuspid insufficiency, I07.2 — Rheumatic tricuspid stenosis and insufficiency, I07.8 — Other rheumatic tricuspid valve diseases, I07.9 — Rheumatic tricuspid valve disease, unspecified, I08.0 — Rheumatic disorders of both mitral and aortic valves, I08.1 — Rheumatic disorders of both mitral and tricuspid valves, I08.2 — Rheumatic disorders of both aortic and tricuspid valves, I08.3 — Combined rheumatic disorders of mitral, aortic and tricuspid valves, I08.8 — Other rheumatic multiple valve diseases, I08.9 — Rheumatic multiple valve disease, unspecified, I09.0 — Rheumatic myocarditis, I09.1 — Rheumatic diseases of endocardium, valve unspecified, I09.2 — Chronic rheumatic pericarditis, I09.81 — Rheumatic heart failure, I09.9 — Rheumatic heart disease, unspecified, +6 more

Same Index main term, other category

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

I07.1 — Rheumatic tricuspid insufficiency (tricuspid), I07.2 — Rheumatic tricuspid stenosis and insufficiency (tricuspid, with, obstruction or stenosis), I07.8 — Other rheumatic tricuspid valve diseases (tricuspid, with, rheumatic fever, inactive or quiescent), I07.9 — Rheumatic tricuspid valve disease, unspecified (tricuspid), I08.0 — Rheumatic disorders of both mitral and aortic valves (mitral, with, aorticdisease), I08.1 — Rheumatic disorders of both mitral and tricuspid valves (mitral, with, tricuspiddisease), I08.2 — Rheumatic disorders of both aortic and tricuspid valves (aortic, with, tricuspiddisease), I08.3 — Combined rheumatic disorders of mitral, aortic and tricuspid valves (tricuspid, with, mitraldisease, aorticdisease), I08.8 — Other rheumatic multiple valve diseases (multiple valves, specified disorders), I08.9 — Rheumatic multiple valve disease, unspecified (multiple valves), I13.2 — Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease (cardiorenal, hypertensive), I24.89 — Other forms of acute ischemic heart disease (coronary), I25.89 — Other forms of chronic ischemic heart disease (coronary), I28.8 — Other diseases of pulmonary vessels (pulmonary), I33.0 — Acute and subacute infective endocarditis (lenta), I33.9 — Acute and subacute endocarditis, unspecified (toxic), I34.0 — Nonrheumatic mitral (valve) insufficiency (mitral), I34.2 — Nonrheumatic mitral (valve) stenosis (mitral, specified cause, except rheumatic), I34.89 — Other nonrheumatic mitral valve disorders (mitral, nonrheumatic), I35.0 — Nonrheumatic aortic (valve) stenosis (aortic), +505 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Prothrombin Time Test and INR (PT/INR)

Contextual Map

Every relationship of I09.89 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 I09.89 with these 3 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

  • I01 — Rheumatic fever with heart involvement[Excludes1](via I09.-): “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-fy2026
  • I37 — Nonrheumatic pulmonary valve disorders[Excludes1]: “pulmonary valve disorder specified as rheumatic (I09.89)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Excludes2 notes

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • MDC 05 — Diseases and Disorders of the Circulatory System[MDC crossing]: “Diseases and Disorders of the Circulatory System — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 15,708 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027

Index entries (15)

  • Arteritis, coronary (artery), rheumatic, chronic[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Disease, diseased, heart (organic), rheumatic (chronic) (inactive) (old) (quiescent) (with chorea), specified NEC[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Disease, diseased, heart (organic), with, rheumatic fever (conditions in I00), inactive or quiescent (with chorea), specified NEC[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Disease, diseased, pulmonary, valve, rheumatic[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Endocarditis (chronic) (marantic) (nonbacterial) (thrombotic) (valvular), pulmonary (chronic) (heart) (valve), rheumatic (chronic) (inactive) (with chorea)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Endocarditis (chronic) (marantic) (nonbacterial) (thrombotic) (valvular), pulmonary (chronic) (heart) (valve), with rheumatic fever (conditions in I00), inactive or quiescent (with chorea)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Fever (inanition) (of unknown origin) (persistent) (with chills) (with rigor), rheumatic (active) (acute) (chronic) (subacute), inactive or quiescent with, cardiac hypertrophy[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Fever (inanition) (of unknown origin) (persistent) (with chills) (with rigor), rheumatic (active) (acute) (chronic) (subacute), inactive or quiescent with, endocarditis, pulmonary (valve)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • and 7 more

Nearest codes

Change history

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

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
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 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 structured 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 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.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

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. "I09.89 — Other specified rheumatic heart diseases." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/i09.89-other-specified-rheumatic-heart-diseases

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Other specified rheumatic heart diseases

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 I09.89 in its code family, with their registry titles.

View all codes in the I09 family