ICD-10 I01
Non-Billable HeaderRheumatic fever with heart involvement
About ICD-10-CM I01
ICD-10-CM code I01 represents Rheumatic fever with heart involvement. This is a non-billable header code in the Circulatory System chapter (block I01). The 2026 edition of ICD-10-CM I01 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Type 1 Excludes
Pure excludes, these codes can never be coded together with I01. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- 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.
Medicare LCD Coverage for I01
Local Coverage Determinations (LCDs) from CMS MACs that list I01 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing I01.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but I01 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with I01
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To I01
Other codes in section I00-I02 (Acute rheumatic fever).
ICD-10 I01, Billing FAQ
Is ICD-10 code I01 billable? +
No, I01 is a non-billable header code. Use a more specific child code from block I01 when submitting claims.
What codes are Type 1 Excludes for I01? +
Type 1 Excludes (never code together with I01): 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.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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