I09.81 — Rheumatic heart failure
Is I09.81 billable?
Yes — I09.81 is billable for FY2027. I09.81 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. I09.81 may be submitted for encounters from October 1, 2026 through September 30, 2027.
I09.81 at a glance
| Code | I09.81 |
|---|---|
| Description | Rheumatic heart failure |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Which MS-DRGs does I09.81 group to?
I09.81 sits in MDC 05 and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 291Heart Failure and Shock with MCCmedical
- 292Heart Failure and Shock with CCmedical
- 293Heart Failure and Shock without CC/MCCmedical
As a secondary diagnosis, I09.81 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is I09.81 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to I09.81. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Failure, failed › heart › congestive › rheumatic
- Failure, failed › ventricular › left › rheumatic
- Fever › rheumatic › inactive or quiescent with › heart failure (inanition) (of unknown origin) (persistent) (with chills) (with rigor)
- Fever › rheumatic › inactive or quiescent with › left ventricular failure (inanition) (of unknown origin) (persistent) (with chills) (with rigor)
- Failure, failed › heart › congestive › with rheumatic fever › inactive or quiescent
- Failure, failed › ventricular › left › with rheumatic fever › inactive or quiescent
Use additional code
Report an additional code alongside I09.81 to fully describe the condition. I09.81 is sequenced first.
- code to identify type of heart failure (I50.-)
Excludes2 — not included here — inherited from Chapter 9
The conditions below are not part of I09.81, but a patient may have both at the same time. When documentation supports it, I09.81 and the excluded code may both be reported.
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
- systemic connective tissue disorders (M30-M36)
- transient cerebral ischemic attacks and related syndromes (G45.-)
How long has I09.81 existed?
I09.81 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.