`I09.81` Rheumatic heart failure

Billable ICD-10-CM code, FY2026. Acts as a Complication or Comorbidity (CC) as a secondary diagnosis.

Risk adjustment (HCC)

Defines the logic of DRG(s) 291-293 in MDC 05.

Type 1 Excludes: I01 Rheumatic fever with heart involvement ("chronic diseases of rheumatic origin (I05-I09) unless rheumatic fever is also present or there is evidence of reactivation or activity of the rheumatic process.")
Type 2 Excludes: I51 Complications and ill-defined descriptions of heart disease ("heart disease specified as rheumatic (I00-I09)")

Failure, failed › heart (acute) (senile) (sudden) › congestive › with rheumatic fever (conditions in I00) › inactive or quiescent (with chorea)
Failure, failed › heart (acute) (senile) (sudden) › congestive › rheumatic (chronic) (inactive) (with chorea)
Failure, failed › ventricular › left › with rheumatic fever (conditions in I00) › inactive or quiescent (with chorea)
Failure, failed › ventricular › left › rheumatic (chronic) (inactive) (with chorea)
Fever (inanition) (of unknown origin) (persistent) (with chills) (with rigor) › rheumatic (active) (acute) (chronic) (subacute) › inactive or quiescent with › heart failure (congestive) (conditions in category I50.)
Fever (inanition) (of unknown origin) (persistent) (with chills) (with rigor) › rheumatic (active) (acute) (chronic) (subacute) › inactive or quiescent with › left ventricular failure (conditions in I50.1-I50.4-)