ICD-10 Guide

Acute Pericarditis

ICD-10 Coding for Acute Pericarditis(I30.0, I30.1, I30.9)

PRIMARY SPECIALTYEmergency Medicine

COMPLEXITYHigh

LAST UPDATED09/15/2025

Sam Tuffun, PT, DPT

Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Acute Pericarditis?

Essential facts and insights about Acute Pericarditis

Key Clinical Considerations:

Typical symptoms include sharp chest pain, which may worsen with deep breathing or coughing, and may be relieved by sitting forward.
Laboratory findings may include elevated inflammatory markers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR).
Physical examination may reveal a pericardial friction rub upon auscultation.
Imaging findings may include an enlarged cardiac silhouette on chest X-ray or echocardiographic evidence of pericardial effusion.
Severity can be assessed based on the presence of complications such as cardiac tamponade or constrictive pericarditis.

Clinical Information

Clinical Criteria & Documentation Requirements

Document the patient's presenting symptoms, duration, and any exacerbating or relieving factors.
Use specific terminology such as 'acute pericarditis' and include any associated symptoms like fever or dyspnea.
Examples include: 'Patient presents with acute chest pain and pericardial rub, diagnosed with acute pericarditis.'
Document medical necessity by including the rationale for diagnostic tests and treatments initiated.
Quality measures may include documentation of symptom assessment and follow-up plans.

Coding Guidelines

Usage Guidelines & Examples

Use I30.0 for acute pericarditis due to infectious agents, I30.1 for acute pericarditis due to other specified causes, and I30.9 for unspecified acute pericarditis.
Do not use these codes for chronic pericarditis or pericardial effusion without acute inflammation.
Similar codes include I31.9 (other diseases of pericardium) and I40.0 (acute myocarditis), which should not be confused with acute pericarditis.
Common errors include misclassifying acute pericarditis as chronic or failing to specify the cause.
In complex cases, ensure to document the underlying cause and any associated conditions to select the appropriate code.

Code Exclusions

Important Exclusions

Exclude chronic pericarditis (I31.9) and pericardial effusion without acute inflammation.
Alternative codes for excluded conditions include I31.9 for other diseases of the pericardium.
Conditions are excluded to ensure accurate representation of acute inflammatory processes.
Common mistakes include coding acute pericarditis when the patient has chronic conditions.
Related but distinct conditions include myocarditis and pleuritis, which require different coding.

Specialty Focus

Primary Specialty

Emergency Medicine

Specialty Applications

Applies to patients with acute inflammatory conditions of the pericardium.
Patient populations include adults and adolescents, with risk factors such as recent viral infections or autoimmune diseases.
Clinical settings include emergency departments, inpatient care, and outpatient follow-ups.
Specialty-specific applications are relevant in cardiology and emergency medicine.
Treatment contexts include acute management of chest pain and follow-up for potential complications.

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

Comprehensive clinical documentation
Accurate code selection based on clinical criteria
Proper exclusion considerations
Specialty-specific coding guidelines

Documentation

Documentation Templates

Template 1

Template: 'Patient diagnosed with acute pericarditis based on clinical findings of chest pain and pericardial rub.'

Template 2

Template: 'Clinical presentation consistent with acute pericarditis including sharp chest pain and fever.'

Template 3

Template: 'Diagnostic criteria for acute pericarditis met as evidenced by echocardiographic findings of pericardial effusion.'

Template 4

Template: 'Treatment plan initiated for acute pericarditis with NSAIDs and follow-up echocardiogram scheduled.'

Template 5

Template: 'Follow-up care for acute pericarditis including monitoring for recurrence of symptoms.'

Billing Information

Billing Considerations

Ensure proper documentation for billing
Verify code specificity requirements
Check for any additional codes needed
Review payer-specific guidelines

Common Issues

Insufficient clinical documentation
Incorrect code selection
Missing supporting diagnoses
Timing and frequency documentation

Frequently Asked Questions

What documentation is required for this diagnosis?

Documentation should include clinical findings, diagnostic tests, and treatment plans.

How does this differ from similar diagnoses?

Acute pericarditis is characterized by inflammation of the pericardium, while myocarditis involves inflammation of the heart muscle.

What are common billing considerations?

Ensure that the diagnosis is supported by clinical documentation to optimize reimbursement.

What procedures are typically associated?

Related CPT codes may include echocardiography and pericardiocentesis.

Are there any quality reporting implications?

Quality measures may include tracking symptom resolution and follow-up care compliance.

What is Acute Pericarditis?

Essential facts and insights about Acute Pericarditis

Key Clinical Considerations:

Typical symptoms include sharp chest pain, which may worsen with deep breathing or coughing, and may be relieved by sitting forward.
Laboratory findings may include elevated inflammatory markers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR).
Physical examination may reveal a pericardial friction rub upon auscultation.
Imaging findings may include an enlarged cardiac silhouette on chest X-ray or echocardiographic evidence of pericardial effusion.
Severity can be assessed based on the presence of complications such as cardiac tamponade or constrictive pericarditis.

Acute Pericarditis

Diagnosis Overview

Key Clinical Considerations:

Clinical Information

Clinical Criteria & Documentation Requirements

Coding Guidelines

Usage Guidelines & Examples

Code Exclusions

Important Exclusions

Related ICD-10 Codes

Related CPT Codes

Specialty Focus

Primary Specialty

Specialty Applications

Coding Complexity

Documentation

Documentation Templates

Template 1

Template 2

Template 3

Template 4

Template 5

Billing Information

Billing Considerations

Common Issues

Frequently Asked Questions

What documentation is required for this diagnosis?

How does this differ from similar diagnoses?

What are common billing considerations?

What procedures are typically associated?

Are there any quality reporting implications?

Acute Pericarditis

Diagnosis Overview

Key Clinical Considerations:

Clinical Information

Clinical Criteria & Documentation Requirements

Coding Guidelines

Usage Guidelines & Examples

Code Exclusions

Important Exclusions

Related ICD-10 Codes

Related CPT Codes

Specialty Focus

Primary Specialty

Specialty Applications

Coding Complexity

Documentation

Documentation Templates

Template 1

Template 2

Template 3

Template 4

Template 5

Billing Information

Billing Considerations

Common Issues

Frequently Asked Questions

What documentation is required for this diagnosis?

How does this differ from similar diagnoses?

What are common billing considerations?

What procedures are typically associated?

Are there any quality reporting implications?