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

ICD-10 I39

Billable / Specific CC

Endocarditis and heart valve disorders in diseases classified elsewhere

I39
Block
0
Synonyms
345
LCDs
15
Payer Policies
0
Linked CPTs

About ICD-10-CM I39

ICD-10-CM code I39 represents Endocarditis and heart valve disorders in diseases classified elsewhere. This is a billable/specific code in the Circulatory System chapter (block I39). The 2026 edition of ICD-10-CM I39 became effective on October 1, 2025.

Coding Tips for I39

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

Inpatient DRG impact: CC

I39 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.

Type 1 Excludes

Pure excludes, these codes can never be coded together with I39. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • endocardial involvement in:
  • candidiasis (B37.6)
  • gonococcal infection (A54.83)
  • Libman-Sacks disease (M32.11)
  • listerosis (A32.82)
  • meningococcal infection (A39.51)
  • rheumatoid arthritis (M05.31)
  • syphilis (A52.03)
  • tuberculosis (A18.84)
  • typhoid fever (A01.02)

Coding Notes

Code First

  • underlying disease, such as:
  • Q fever (A78)

Inpatient DRG Impact, CC

codes Endocarditis and heart valve disorders in diseases classified elsewhere. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for I39

Local Coverage Determinations (LCDs) from CMS MACs that list I39 as a covered diagnosis.

345 LCDs

Showing top 10 of 345 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 I39.

15 policies

1 Aetna

Color-Flow Doppler Echocardiography and Myocardial Strain Imaging - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0008

1 Cigna

Transthoracic Echocardiography in Adults - (0510)
Policy ID: MM_0510

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 I39

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

No procedure linkages on file for I39

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 I39 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
I39 4211 10000
I39 42491 10000

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

ICD-10 I39, Billing FAQ

Is ICD-10 code I39 billable? +

Yes, I39 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What codes are Type 1 Excludes for I39? +

Type 1 Excludes (never code together with I39): endocardial involvement in:; candidiasis (B37.6); gonococcal infection (A54.83)

Is I39 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 ICD-9 codes does I39 map to? +

Per CMS GEMs, I39 maps to ICD-9 codes: 4211, 42491. 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 July 16, 2026.

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