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ICD-10 Guide
ICD-10 CodesI09.89

I09.89

Billable

Other specified rheumatic heart diseases

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 I09.89 is a billable code used to indicate a diagnosis of other specified rheumatic heart diseases.

Key Diagnostic Point:

I09.89 refers to other specified rheumatic heart diseases, which encompass a variety of cardiac conditions resulting from rheumatic fever, a complication of untreated streptococcal throat infections. Clinically, patients may present with symptoms such as dyspnea, palpitations, chest pain, and signs of heart failure. The anatomy involved typically includes the heart valves, particularly the mitral and aortic valves, which may become stenotic or regurgitant due to inflammatory changes. Disease progression can lead to chronic heart failure, arrhythmias, and increased risk of infective endocarditis. Diagnostic considerations include echocardiography to assess valve function and structure, as well as laboratory tests to identify streptococcal infection and inflammatory markers. Accurate diagnosis is crucial for effective management and prevention of complications associated with rheumatic heart disease.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough clinical evaluation and imaging studies.
  • Treatment complexity: Management may involve medical therapy, surgical intervention, or both.
  • Documentation requirements: Detailed clinical history and evidence of rheumatic fever are essential.
  • Coding specificity: Requires differentiation from other heart conditions.

Audit Risk Factors

  • Common coding errors: Misclassification of rheumatic heart disease types.
  • Documentation gaps: Incomplete clinical history or lack of supporting evidence.
  • Billing challenges: Potential denials due to insufficient documentation or incorrect code selection.

Specialty Focus

Medical Specialties

Cardiology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Primary Care

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Rheumatic heart disease significantly impacts population health, particularly in regions with limited access to healthcare. It contributes to increased morbidity and mortality rates, particularly among younger populations. Quality measures focus on early diagnosis and treatment of streptococcal infections to prevent rheumatic fever and subsequent heart disease. Understanding healthcare utilization patterns related to I09.89 can inform public health strategies aimed at reducing the incidence of rheumatic heart disease.

ICD-9 vs ICD-10

Rheumatic heart disease significantly impacts population health, particularly in regions with limited access to healthcare. It contributes to increased morbidity and mortality rates, particularly among younger populations. Quality measures focus on early diagnosis and treatment of streptococcal infections to prevent rheumatic fever and subsequent heart disease. Understanding healthcare utilization patterns related to I09.89 can inform public health strategies aimed at reducing the incidence of rheumatic heart disease.

Reimbursement & Billing Impact

reimbursement and minimize audit risks.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for I00-I99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for I00-I99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by I09.89?

I09.89 includes various rheumatic heart diseases not specifically classified elsewhere, such as rheumatic heart disease with unspecified valve involvement or those with atypical presentations.

When should I09.89 be used instead of related codes?

Use I09.89 when the rheumatic heart disease does not fit into more specific categories, ensuring that the clinical documentation supports the diagnosis.

What documentation supports I09.89?

Documentation should include a detailed patient history of rheumatic fever, clinical findings, echocardiographic evidence of valve involvement, and any relevant laboratory test results.