I00-I02
Medium Complexity

Acute rheumatic fever

Primary Specialty: Cardiology
Last Updated: 2025-09-10

ICD-10 Codes (9)

7 billable
0 category headers
I01
Rheumatic fever with heart involvement
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I01.0
Billable
Acute rheumatic pericarditis
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I01.1
Billable
Acute rheumatic endocarditis
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I01.2
Billable
Acute rheumatic myocarditis
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I01.8
Billable
Other acute rheumatic heart disease
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I01.9
Billable
Acute rheumatic heart disease, unspecified
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I02
Rheumatic chorea
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I02.0
Billable
Rheumatic chorea with heart involvement
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I02.9
Billable
Rheumatic chorea without heart involvement
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Updates & Changes

FY 2026 Updates

Current Year

New Codes (1)

I16.9
Hypertensive crisis, unspecified, with target organ damage

Revised Codes (2)

I12.0
Hypertensive chronic kidney disease with stage 5 chronic kidney disease - updated staging
I15.9
Secondary hypertension, unspecified - enhanced documentation requirements

Deleted Codes

No codes deleted in this range for FY 2026

Historical Changes

  • FY 2025: Routine maintenance updates with minor terminology clarifications
  • FY 2024: Enhanced specificity requirements for certain code ranges
  • FY 2023: Updated documentation guidelines for improved clarity

Upcoming Changes

  • Proposed updates pending review by Coordination and Maintenance Committee
  • Under consideration: Enhanced digital health integration codes

Implementation Guidance

  • Review all FY 2026 updates for I00-I02 codes before implementation
  • Always verify the most current codes in the ICD-10-CM manual
  • Ensure clinical documentation supports the selected diagnosis codes
  • +3 more guidance items...

Range Overview

high priority

The I00-I02 range in the ICD-10 pertains to Acute Rheumatic Fever (ARF), a systemic inflammatory disease that can develop as a delayed reaction to pharyngitis caused by group A beta-hemolytic streptococci. The codes in this category are used to classify the various manifestations and stages of ARF, including rheumatic fever without heart involvement (I00), rheumatic fever with heart involvement (I01), and chronic rheumatic heart diseases (I02).

Key Usage Points:

  • I00 is used when ARF occurs without any heart involvement.
  • I01 is used when ARF occurs with heart involvement.
  • I02 is used to denote chronic rheumatic heart diseases.
  • Specificity is crucial; the more specific the code, the more accurate the billing.
  • Always check for updates or changes in the ICD-10 guidelines.

Coding Guidelines

When to Use:

  • When a patient is diagnosed with ARF without heart involvement.
  • When a patient is diagnosed with ARF with heart involvement.
  • When a patient has a history of ARF and is now suffering from chronic rheumatic heart diseases.
  • When ARF is a significant part of the patient's medical history.

When NOT to Use:

  • When the patient has a different type of heart disease not caused by ARF.
  • When the patient has a rheumatic condition not related to ARF.
  • When the patient has a history of ARF but no current symptoms or complications.
  • When the patient has streptococcal pharyngitis but no diagnosis of ARF.

Code Exclusions

Always verify the exclusions with the patient's medical history and the physician's notes.

Documentation Requirements

Accurate documentation is crucial for coding ARF. The documentation should clearly state the diagnosis, specify whether the heart is involved, and describe any chronic conditions resulting from ARF.

Clinical Information:

  • Confirmation of ARF diagnosis
  • Details on heart involvement
  • Description of chronic conditions
  • Patient's medical history
  • Current symptoms and their severity

Supporting Evidence:

  • Lab reports confirming streptococcal infection
  • Cardiac test results
  • Physician's examination notes
  • Patient's symptom descriptions
Good Documentation Example:

Patient diagnosed with Acute Rheumatic Fever with heart involvement. Echocardiogram shows mild mitral regurgitation. History of streptococcal pharyngitis 3 weeks ago.

Poor Documentation Example:

Patient has fever and joint pain.

Common Documentation Errors:

  • Not specifying heart involvement
  • Not including chronic conditions
  • Not confirming ARF diagnosis
  • Not providing enough detail on symptoms

Range Statistics

3
Total Codes
7
Billable
Complexity:
Medium
Primary Use:Clinical Documentation
Chapter:9

Coding Complexity

Medium
Complexity Rating

Coding for ARF can be moderately complex due to the need to determine heart involvement, identify chronic conditions, interpret supporting evidence, navigate exclusions, and stay current with guideline updates.

Key Factors:
  • Determining heart involvement
  • Identifying chronic conditions
  • Interpreting supporting evidence
  • Navigating exclusions
  • Keeping up with guideline updates

Specialty Focus

These codes are primarily used by cardiologists and rheumatologists. However, they may also be used by general practitioners and pediatricians.

Primary Specialties:
Cardiology
50%
Rheumatology
30%
General Practice
20%
Clinical Scenarios:
  • A patient presents with a history of streptococcal pharyngitis and current symptoms of fever and joint pain.
  • A patient with a history of ARF presents with symptoms of heart failure.
  • A patient presents with recurrent episodes of ARF.
  • A patient with a history of ARF is diagnosed with chronic rheumatic heart disease.

Resources & References

There are many resources available for coding ARF, including the official ICD-10 guidelines, clinical reference books, and educational materials.

Official Guidelines:

  • ICD-10-CM Official Guidelines for Coding and Reporting
  • American Health Information Management Association (AHIMA) guidelines
  • Centers for Disease Control and Prevention (CDC) guidelines

Clinical References:

  • Harrison's Principles of Internal Medicine
  • The Merck Manual of Diagnosis and Therapy

Educational Materials:

  • AHIMA's ICD-10 training materials
  • American Academy of Professional Coders (AAPC) educational resources

Frequently Asked Questions

What is the difference between I00 and I01?

I00 is used for ARF without heart involvement, while I01 is used for ARF with heart involvement.

Can I use I00-I02 for a patient with a history of ARF but no current symptoms?

No, these codes should only be used for active cases of ARF or chronic conditions resulting from ARF.