ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 I09.1

Billable / Specific

Rheumatic diseases of endocardium, valve unspecified

I09
Block
2
Synonyms
323
LCDs
11
Payer Policies
0
Linked CPTs

About ICD-10-CM I09.1

ICD-10-CM code I09.1 represents Rheumatic diseases of endocardium, valve unspecified. This is a billable/specific code in the Circulatory System chapter (block I09). The 2026 edition of ICD-10-CM I09.1 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under I09.1. Per CMS ICD-10-CM Tabular 2026.

  • Rheumatic endocarditis (chronic)
  • Rheumatic valvulitis (chronic)

Type 1 Excludes

Pure excludes, these codes can never be coded together with I09.1. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • endocarditis, valve unspecified (I38)

Medicare LCD Coverage for I09.1

Local Coverage Determinations (LCDs) from CMS MACs that list I09.1 as a covered diagnosis.

323 LCDs

Showing top 10 of 323 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93313 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93312 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93318 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93317 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT C8927 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT C8925 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93314 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT C8926 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93316 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93315 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing I09.1.

11 policies

5 Medicare

Billing and Coding: Cardiac Catheterization and Coronary Angiography
Policy ID: ART-52850
Billing and Coding: Transesophageal Echocardiography (TEE)
Policy ID: ART-52868
Billing and Coding: Cardiac Radionuclide Imaging
Policy ID: ART-56476
Billing and Coding: Cardiac Catheterization and Coronary Angiography
Policy ID: ART-56500
Billing and Coding: Transesophageal Echocardiography (TEE)
Policy ID: ART-56505

CPT Codes Commonly Billed with I09.1

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for I09.1

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.

Convert I09.1 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
I09.1 3979 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 I09.1, Billing FAQ

Is ICD-10 code I09.1 billable? +

Yes, I09.1 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to I09.1? +

ICD-10 I09.1 includes: Rheumatic endocarditis (chronic); Rheumatic valvulitis (chronic).

What codes are Type 1 Excludes for I09.1? +

Type 1 Excludes (never code together with I09.1): endocarditis, valve unspecified (I38)

What ICD-9 codes does I09.1 map to? +

Per CMS GEMs, I09.1 maps to ICD-9 codes: 3979. Useful for legacy data review and historical claim analysis.

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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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