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I38BillableSave

I38 - Endocarditis, valve unspecified

ICD-10-CM Chapter 9: Diseases of the circulatory system · I30-I5A Other forms of heart disease (I30-I5A) · Top-level category · FY2027

Includes, Excludes and Coding Notes

IncludesFrom I38

Conditions this code covers.

  • endocarditis (chronic) NOS
  • valvular incompetence NOS
  • valvular insufficiency NOS
  • valvular regurgitation NOS
  • valvular stenosis NOS
  • valvulitis (chronic) NOS
Excludes 1 — Not Coded HereFrom I38

Mutually exclusive: these conditions are never reported together with this code.

  • congenital insufficiency of cardiac valve NOS (Q24.8)
  • congenital stenosis of cardiac valve NOS (Q24.8)
  • endocardial fibroelastosis (I42.4)
  • endocarditis specified as rheumatic (I09.1)
Excludes 2 — Not Included HereFrom Chapter I00-I99

Not part of this code; report both codes when the patient has both conditions.

  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
  • systemic connective tissue disorders (M30-M36)
  • transient cerebral ischemic attacks and related syndromes (G45.-)

Inpatient DRG Payments

DRG 3063,472 discharges

Cardiac Congenital And Valvular Disorders With Mcc

Avg. Medicare Payment

$13,030

Total Payment$15,565
Patient Responsibility$2,535
Hospital Charge$72,644
DRG 3072,600 discharges

Cardiac Congenital And Valvular Disorders Without Mcc

Avg. Medicare Payment

$7,637

Total Payment$9,659
Patient Responsibility$2,022
Hospital Charge$48,722