ICD-10 I41
Billable / Specific MCCMyocarditis in diseases classified elsewhere
About ICD-10-CM I41
ICD-10-CM code I41 represents Myocarditis in diseases classified elsewhere. This is a billable/specific code in the Circulatory System chapter (block I41). The 2026 edition of ICD-10-CM I41 became effective on October 1, 2025.
Coding Tips for I41
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
I41 is designated MCC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-MCC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag MCC 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 I41. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- myocarditis (in):
- Chagas' disease (chronic) (B57.2)
- acute (B57.0)
- coxsackie (virus) infection (B33.22)
- diphtheritic (A36.81)
- gonococcal (A54.83)
- influenzal (J09.X9, J10.82, J11.82)
- meningococcal (A39.52)
- mumps (B26.82)
- rheumatoid arthritis (M05.31)
- sarcoid (D86.85)
- syphilis (A52.06)
- toxoplasmosis (B58.81)
- tuberculous (A18.84)
Coding Notes
Code First
- underlying disease, such as:
- typhus (A75.0-A75.9)
Inpatient DRG Impact, MCC
codes Myocarditis in diseases classified elsewhere. As a Major Complication/Comorbidity (MCC), this can shift the DRG assignment to a higher-weighted category, substantial reimbursement impact.
Medicare LCD Coverage for I41
Local Coverage Determinations (LCDs) from CMS MACs that list I41 as a covered diagnosis.
Showing top 10 of 272 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing I41.
3 Cigna
5 Medicare
CPT Codes Commonly Billed with I41
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.
Convert I41 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 |
|---|---|---|
| I41 | 4220 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To I41
Other codes in section I30-I5A (Other forms of heart disease).
ICD-10 I41, Billing FAQ
Is ICD-10 code I41 billable? +
Yes, I41 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 I41? +
Type 1 Excludes (never code together with I41): myocarditis (in):; Chagas' disease (chronic) (B57.2); acute (B57.0)
Is I41 a CC or MCC for inpatient DRG? +
Yes, this code is designated as MCC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What ICD-9 codes does I41 map to? +
Per CMS GEMs, I41 maps to ICD-9 codes: 4220. 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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