I09.81
Rheumatic heart failure
I09.81 (also written I0981) is a billable ICD-10-CM diagnosis code for rheumatic heart failure. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 6 codes in category I09 (Other rheumatic heart diseases). The Alphabetic Index lists it under 6 entries. Its coding notes include a Use additional code instruction and 10 Excludes2 entries.
Use additional code
Add the listed code as a secondary code, if known.
- code to identify type of heart failure (I50.-)
Excludes2
Not included here. Both codes may be reported if the patient has both conditions.
Also from chapter/block level (10 notes)
- 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.-)
Care settings
How CMS programs treat this code. These are CMS claim edits and list entries, not coverage or eligibility rules.
Home Health Primary
Accepted as the primary (principal) diagnosis on a home health claim. The Home Health Grouper assigns it to the MMTA - Cardiac and Circulatory clinical group.
Source: CMS Home Health Grouper Software v07.2.26, effective October 1, 2026Hospital CC
Counts as a complication or comorbidity (CC) when reported as a secondary diagnosis on an inpatient claim. It does not count when the principal diagnosis is one of the 33 codes in its exclusion list. Some MS-DRGs also ignore a CC or MCC that defines the DRG.
Source: CMS MS-DRG Definitions Manual v44, effective October 1, 2026, Appendix CAlphabetic Index terms
Terms the official Alphabetic Index lists for this code. 6 entries
- Failure, failed, heart (acute) (senile) (sudden), congestive, rheumatic (chronic) (inactive) (with chorea)
- Failure, failed, heart (acute) (senile) (sudden), congestive, with rheumatic fever (conditions in I00), inactive or quiescent (with chorea)
- Failure, failed, ventricular, left, rheumatic (chronic) (inactive) (with chorea)
- Failure, failed, ventricular, left, with rheumatic fever (conditions in I00), inactive or quiescent (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-)