ICD-10 I05
Non-Billable HeaderRheumatic mitral valve diseases
About ICD-10-CM I05
ICD-10-CM code I05 represents Rheumatic mitral valve diseases. This is a non-billable header code in the Circulatory System chapter (block I05). The 2026 edition of ICD-10-CM I05 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 I05. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- mitral valve disease specified as nonrheumatic (I34.-)
- mitral valve disease with aortic and/or tricuspid valve involvement (I08.-)
Includes
- conditions classifiable to both I05.0 and I05.2-I05.9, whether specified as rheumatic or not
Medicare LCD Coverage for I05
Local Coverage Determinations (LCDs) from CMS MACs that list I05 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 I05.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but I05 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with I05
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 I05
Other codes in section I05-I09 (Chronic rheumatic heart diseases).
ICD-10 I05, Billing FAQ
Is ICD-10 code I05 billable? +
No, I05 is a non-billable header code. Use a more specific child code from block I05 when submitting claims.
What codes are Type 1 Excludes for I05? +
Type 1 Excludes (never code together with I05): mitral valve disease specified as nonrheumatic (I34.-); mitral valve disease with aortic and/or tricuspid valve involvement (I08.-)
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team