ICD-10 I07
Non-Billable HeaderRheumatic tricuspid valve diseases
About ICD-10-CM I07
ICD-10-CM code I07 represents Rheumatic tricuspid valve diseases. This is a non-billable header code in the Circulatory System chapter (block I07). The 2026 edition of ICD-10-CM I07 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 I07. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- tricuspid valve disease specified as nonrheumatic (I36.-)
- tricuspid valve disease with aortic and/or mitral valve involvement (I08.-)
Includes
- rheumatic tricuspid valve diseases specified as rheumatic or unspecified
Medicare LCD Coverage for I07
Local Coverage Determinations (LCDs) from CMS MACs that list I07 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 I07.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but I07 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with I07
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 I07
Other codes in section I05-I09 (Chronic rheumatic heart diseases).
ICD-10 I07, Billing FAQ
Is ICD-10 code I07 billable? +
No, I07 is a non-billable header code. Use a more specific child code from block I07 when submitting claims.
What codes are Type 1 Excludes for I07? +
Type 1 Excludes (never code together with I07): tricuspid valve disease specified as nonrheumatic (I36.-); tricuspid valve disease with aortic and/or mitral valve involvement (I08.-)
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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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