I48.1 ICD-10-CM Code: Persistent atrial fibrillation
Billing Status: NO. This is a clinician non-billable / parent hierarchy grouping in the ICD-10-CM system.
Coding at a Glance
- Tabular directives
- 1 Excludes1
Coding instructions
Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for I48.1 in the official ICD-10-CM tabular list, quoted as published.
Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025
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).
- Permanent atrial fibrillation (I48.21) Compare I48.1 vs I48.21 →
Coder workflow for I48.1
MedCoder structured workflow — derived from this code’s own official record
Before you code I48.1
- I48.1 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).
See the relationships section · Guide: How to choose an ICD-10-CM code →
- Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with I48.1. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).
Choose the right path
- Does the documentation support one of the more specific codes beneath I48.1?
Yes → Select that code and continue the checks below on its own page.
No → I48.1 cannot be reported as written; query for the specificity its subcategory needs. - Does the documentation support a condition named in I48.1’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.ReviewI48.21
Consider I48.1. 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).
Official instructions as workflow
Excludes1 — check before selecting I48.1(1 note)
Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with I48.1: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.
CompareI48.21
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 I48.1 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).
ReviewI48.21
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
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 structured relationships — computed from published CMS and AHRQ datasets
Other codes that name I48.1 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: R00 — Abnormalities of heart beat (via I48.-).
These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.
Referenced by 1 Code Also instruction: M35.81 — Multisystem inflammatory syndrome (via I48.-).
These codes suggest coding this condition alongside when both are present.
Clinical classification (AHRQ CCSR):CIR017 — Cardiac dysrhythmias (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 (Cardiac dysrhythmias).
I47.1 — Supraventricular tachycardia, I47.10 — Supraventricular tachycardia, unspecified, I47.11 — Inappropriate sinus tachycardia, so stated, I47.19 — Other supraventricular tachycardia, I47.2 — Ventricular tachycardia, I47.20 — Ventricular tachycardia, unspecified, I47.21 — Torsades de pointes, I47.29 — Other ventricular tachycardia, I47.9 — Paroxysmal tachycardia, unspecified, I48.0 — Paroxysmal atrial fibrillation, I48.11 — Longstanding persistent atrial fibrillation, I48.19 — Other persistent atrial fibrillation, I48.2 — Chronic atrial fibrillation, I48.20 — Chronic atrial fibrillation, unspecified, I48.21 — Permanent atrial fibrillation, I48.3 — Typical atrial flutter, I48.4 — Atypical atrial flutter, I48.91 — Unspecified atrial fibrillation, I48.92 — Unspecified atrial flutter, I49.1 — Atrial premature depolarization, +8 more
Contextual Map
Every relationship of I48.1 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 I48.1 with these 3 related codes in Claim Check
Hierarchy
- I00-I99 — Chapter 9: Diseases of the Circulatory System (I00-I99) (I00-I99)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- I30-I5A — Other forms of heart disease[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Excludes1
- I48.21 — Permanent atrial fibrillation[Excludes1]: “Permanent atrial fibrillation (I48.21)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Referenced by Excludes2 notes
- R00 — Abnormalities of heart beat[Excludes2](via I48.-): “specified arrhythmias (I47-I49)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Referenced by Code Also instructions
- M35.81 — Multisystem inflammatory syndrome[Code Also](via I48.-): “cardiac arrhythmia (I47-I49.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Clinical classification (CCSR)
- CIR017 — Cardiac dysrhythmias[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)
Nearest codes (12)
- I48 — Atrial fibrillation and flutter[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- I48.0 — Paroxysmal atrial fibrillation[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- I48.11 — Longstanding persistent atrial fibrillation[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- I48.19 — Other persistent atrial fibrillation[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- I48.2 — Chronic atrial fibrillation[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- I48.20 — Chronic atrial fibrillation, unspecified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- I48.21 — Permanent atrial fibrillation[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- I48.3 — Typical atrial flutter[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- and 4 more
Change history (2)
- FY2020 — Became a non-billable header[Change history]— CMS release files (code change ledger) · icd10cm-fy2020
- and 1 more
Common coding questions
Can I48.1 be billed directly?
No. I48.1 (Persistent atrial fibrillation) 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 FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
- Claim edits Official source data
- CMS Definitions of Medicare Code Edits — v43.1 (April 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. "I48.1 — Persistent atrial fibrillation." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/i48.1-persistent-atrial-fibrillation
Change history
- FY2020 — October 1, 2019Became a non-billable headerFY2020 changes
- FY2016 — October 1, 2015In the code set at ICD-10-CM adoptionPersistent atrial fibrillation
Nearest Codes in This Family
Official ICD-10-CM classifications closest to I48.1 in its code family, with their registry titles.
- I48 — Atrial fibrillation and flutter
- I48.0 — Paroxysmal atrial fibrillation
- I48.11 — Longstanding persistent atrial fibrillation
- I48.19 — Other persistent atrial fibrillation
- I48.2 — Chronic atrial fibrillation
- I48.20 — Chronic atrial fibrillation, unspecified
- I48.21 — Permanent atrial fibrillation
- I48.3 — Typical atrial flutter
- I48.4 — Atypical atrial flutter
- I48.9 — Unspecified atrial fibrillation and atrial flutter