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I31.3 ICD-10-CM Code: Pericardial effusion (noninflammatory)

Billing Status: NO. This is a clinician non-billable / parent hierarchy grouping in the ICD-10-CM system.

Coding at a Glance

Tabular directives
4 Excludes1

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for I31.3 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

Notes without a marker are published on I31.3 itself; “inherited from” names the category or block whose note applies here.

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).

Coder workflow for I31.3

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

Before you code I31.3

  1. I31.3 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).

    ReviewI31.31, I31.39

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

  2. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with I31.3. 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 I31.3?
    Yes → Select that code and continue the checks below on its own page.
    No → I31.3 cannot be reported as written; query for the specificity its subcategory needs.

    ReviewI31.31, I31.39

  2. Does the documentation support a condition named in I31.3’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.

    ReviewI30.9, I09.2, I97.0, S26

Consider I31.3. Then confirm the code is valid for the date of service in the Verify section.

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).
Acuity
Acute or chronic as documented; when both are documented and separate codes exist, both are reported with the acute code first (Guidelines I.B.8).

Official instructions as workflow

  • Excludes1 — check before selecting I31.3(4 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with I31.3: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareI30.9, I09.2, I97.0, S26

    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 I31.3 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).

ReviewI30.9, I09.2, I97.0, S26

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 I31.3 with…

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

The codes most likely to be picked instead of I31.3 — 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.

  • I30.9— 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 acute pericardial effusion moves the case to I30.9; the two are not reported together unless documented as unrelated.

    Full comparison: I31.3 vs I30.9 →

  • I09.2— 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 diseases of pericardium specified as rheumatic moves the case to I09.2; the two are not reported together unless documented as unrelated.

    Full comparison: I31.3 vs I09.2 →

  • I97.0— 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 postcardiotomy syndrome moves the case to I97.0; the two are not reported together unless documented as unrelated.

    Full comparison: I31.3 vs I97.0 →

  • S26— 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 traumatic injury to pericardium moves the case to S26; the two are not reported together unless documented as unrelated.

    Full comparison: I31.3 vs S26 →

  • I31.9— Specificity relationship (Review)

    Overlapping diagnoses in the same category.

    Overlapping codes in the same category — the documentation decides which is the more specific fit.

    What moves you there: A record that documents no more than “Disease of pericardium, unspecified” takes I31.9; specificity in the record moves it back here.

    Full comparison: I31.3 vs I31.9 →

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.

Code Overview

Pericardial effusion (noninflammatory) is a non-billable ICD-10-CM category code (I31.3). 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

  • Not billable as written — a more specific code is required: I31.31, I31.39.

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 I31.3 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 Excludes1 note: I09.2 — Chronic rheumatic pericarditis (via I31.-).

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

Clinical classification (AHRQ CCSR):CIR006 — Pericarditis and pericardial 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 (Pericarditis and pericardial disease).

A39.53 — Meningococcal pericarditis, B33.23 — Viral pericarditis, I01.0 — Acute rheumatic pericarditis, I09.2 — Chronic rheumatic pericarditis, I30.0 — Acute nonspecific idiopathic pericarditis, I30.1 — Infective pericarditis, I30.8 — Other forms of acute pericarditis, I30.9 — Acute pericarditis, unspecified, I31.0 — Chronic adhesive pericarditis, I31.1 — Chronic constrictive pericarditis, I31.2 — Hemopericardium, not elsewhere classified, I31.31 — Malignant pericardial effusion in diseases classified elsewhere, I31.39 — Other pericardial effusion (noninflammatory), I31.4 — Cardiac tamponade, I31.8 — Other specified diseases of pericardium, I31.9 — Disease of pericardium, unspecified, I32 — Pericarditis in diseases classified elsewhere, M32.12 — Pericarditis in systemic lupus erythematosus

Contextual Map

Every relationship of I31.3 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 I31.3 with these 2 related codes in Claim Check

Hierarchy

Excludes1

Referenced by Excludes1 notes

Clinical classification (CCSR)

Nearest codes (9)

Change history (2)

Common coding questions

Can I31.3 be billed directly?

No. I31.3 (Pericardial effusion (noninflammatory)) 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 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. "I31.3 — Pericardial effusion (noninflammatory)." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/i31.3-pericardial-effusion-noninflammatory

Change history

  • FY2023 — October 1, 2022
    Became a non-billable header
    FY2023 changes
  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Pericardial effusion (noninflammatory)

Nearest Codes in This Family

Official ICD-10-CM classifications closest to I31.3 in its code family, with their registry titles.

View all codes in the I31 family