I43 — Cardiomyopathy in diseases classified elsewhere
Is I43 billable?
Yes — I43 is billable for FY2027. I43 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. I43 may be submitted for encounters from October 1, 2026 through September 30, 2027.
I43 at a glance
| Code | I43 |
|---|---|
| Description | Cardiomyopathy in diseases classified elsewhere |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
What Medicare edits apply to I43?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name I43 directly.
This code describes a manifestation of an underlying disease. The underlying condition must be sequenced before it, so it can never be the principal or first-listed diagnosis.
Which MS-DRGs does I43 group to?
I43 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.
- 314Other Circulatory System Diagnoses with MCCmedical
- 315Other Circulatory System Diagnoses with CCmedical
- 316Other Circulatory System Diagnoses without CC/MCCmedical
As a secondary diagnosis, I43 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is I43 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to I43. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Amyloid heart (disease)
- Cardiomegalia glycogenica diffusa
- Amyloidosis › heart (generalized) (primary)
- Cardiomegaly › glycogen
- Cardiomyopathy › amyloid (familial) (idiopathic)
- Cardiomyopathy › glycogen storage (familial) (idiopathic)
- Cardiomyopathy › metabolic (familial) (idiopathic)
- Cardiomyopathy › nutritional (familial) (idiopathic)
- Cardiomyopathy › thyrotoxic (familial) (idiopathic)
- Glycogenosis › cardiac (diffuse) (generalized)
- Myocardiopathy › glycogen storage (congestive) (constrictive) (familial) (hypertrophic nonobstructive) (idiopathic) (infiltrative) (obstructive) (primary) (restrictive) (sporadic)
- Myocardiopathy › thyrotoxic (congestive) (constrictive) (familial) (hypertrophic nonobstructive) (idiopathic) (infiltrative) (obstructive) (primary) (restrictive) (sporadic)
Excludes1 — never code together
The conditions below can never be reported together with I43 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
Code first
The underlying condition below must be sequenced before I43. I43 describes a manifestation and cannot be the principal or first-listed diagnosis.
Excludes2 — not included here — inherited from Chapter 9
The conditions below are not part of I43, but a patient may have both at the same time. When documentation supports it, I43 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 I43 existed?
I43 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.