ICD-10 I97.190
Billable / Specific CCOther postprocedural cardiac functional disturbances following cardiac surgery
About ICD-10-CM I97.190
ICD-10-CM code I97.190 represents Other postprocedural cardiac functional disturbances following cardiac surgery. This is a billable/specific code in the Circulatory System chapter (block I97). The 2026 edition of ICD-10-CM I97.190 became effective on October 1, 2025.
Coding Tips for I97.190
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
I97.190 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.
Use Additional Code
When coding I97.190, also report these additional codes when applicable.
- code, if applicable, for type 4 or type 5 myocardial infarction, to further specify disorder
Inpatient DRG Impact, CC
codes Other postprocedural cardiac functional disturbances following cardiac surgery. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for I97.190
Local Coverage Determinations (LCDs) from CMS MACs that list I97.190 as a covered diagnosis.
Showing top 10 of 368 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing I97.190.
5 Medicare
2 Aetna
CPT Codes Commonly Billed with I97.190
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 I97.190 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 |
|---|---|---|
| I97.190 | 4294 | 10000 |
| I97.190 | 4294 | 10112 |
| I97.190 | 9971 | 10111 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To I97.190
Other codes in section I95-I99 (Other and unspecified disorders of the circulatory system).
ICD-10 I97.190, Billing FAQ
Is ICD-10 code I97.190 billable? +
Yes, I97.190 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Is I97.190 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 I97.190 map to? +
Per CMS GEMs, I97.190 maps to ICD-9 codes: 4294, 4294, 9971. 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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