ICD-10 I30.1
Billable / Specific CCInfective pericarditis
About ICD-10-CM I30.1
ICD-10-CM code I30.1 represents Infective pericarditis. This is a billable/specific code in the Circulatory System chapter (block I30). The 2026 edition of ICD-10-CM I30.1 became effective on October 1, 2025.
Coding Tips for I30.1
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
I30.1 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under I30.1. Per CMS ICD-10-CM Tabular 2026.
- Pneumococcal pericarditis
- Pneumopyopericardium
- Purulent pericarditis
- Pyopericarditis
- Pyopericardium
- Pyopneumopericardium
- Staphylococcal pericarditis
- Streptococcal pericarditis
- Suppurative pericarditis
- Viral pericarditis
Use Additional Code
When coding I30.1, also report these additional codes when applicable.
- code (B95-B97) to identify infectious agent
Inpatient DRG Impact, CC
codes Infective pericarditis. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for I30.1
Local Coverage Determinations (LCDs) from CMS MACs that list I30.1 as a covered diagnosis.
Showing top 10 of 266 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing I30.1.
5 Medicare
CPT Codes Commonly Billed with I30.1
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 90999 CMS LCD: Billing and Coding: Frequency of Hemodialysis CMS LCD
Convert I30.1 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| I30.1 | 42090 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To I30.1
Other codes in section I30-I5A (Other forms of heart disease).
ICD-10 I30.1, Billing FAQ
Is ICD-10 code I30.1 billable? +
Yes, I30.1 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 I30.1? +
ICD-10 I30.1 includes: Pneumococcal pericarditis; Pneumopyopericardium; Purulent pericarditis, and 7 more clinical synonyms.
Is I30.1 a CC or MCC for inpatient DRG? +
Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What CPT codes are commonly billed with I30.1? +
Procedures frequently paired with I30.1 include: 90999.
What ICD-9 codes does I30.1 map to? +
Per CMS GEMs, I30.1 maps to ICD-9 codes: 42090. 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 May 31, 2026.
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