ICD-10-CM 2027 diagnosis code
I09.81Rheumatic heart failure
I09.81 is a valid, billable ICD-10-CM code for rheumatic heart failure. It can be reported on claims for dates of service from October 1, 2026 – September 30, 2027.
Code unchanged since ICD-10-CM took effect on October 1, 2015. Source: official FY2027 ICD-10-CM release from CDC/NCHS and CMS. Page updated September 29, 2026. About our data
About I09.81
I09.81 is the ICD-10-CM diagnosis code for rheumatic heart failure. It belongs to category I09 (other rheumatic heart diseases), block I05-I09 (chronic rheumatic heart diseases) and chapter 9 (diseases of the circulatory system). It is billable, so it can be reported on its own for dates of service from October 1, 2026 through September 30, 2027.
Within I09.8 (other specified rheumatic heart diseases), I09.81 is specifically for rheumatic heart failure. Related codes cover other specified rheumatic heart diseases (I09.89).
Use an additional code to identify type of heart failure (I50.-).
As a secondary diagnosis it is a CC (complication or comorbidity), which can move an inpatient stay into the "with CC" MS-DRG of its family, unless the principal diagnosis excludes it.
In MS-DRG v44.0, it is part of the grouping logic for DRG 291 (Heart Failure and Shock with MCC, relative weight 1.2685), DRG 292 (Heart Failure and Shock with CC, relative weight 0.8616), DRG 293 (Heart Failure and Shock without CC/MCC, relative weight 0.5462), DRG 791 (Prematurity with Major Problems, relative weight 4.1075) and DRG 793 (Full Term Neonate with Major Problems, relative weight 4.2195), in MDC 05 (Diseases and Disorders of the Circulatory System) and MDC 15 (Newborns and Other Neonates with Conditions Originating in the Perinatal Period), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.
It has been part of ICD-10-CM since the code set took effect on October 1, 2015 and hasn't changed since.
Before ICD-10, this condition was coded in ICD-9-CM as 398.91 (rheumatic heart failure (congestive)).
Coding notes
- code to identify type of heart failure (I50.-)
Notes that apply from higher levels
Instructions written at a parent level also apply to I09.81.
Broader instructions also apply from Chapter 9: Diseases of the circulatory system.
Alphabetic index entries
6 entriesTerms in the official ICD-10-CM index that lead to I09.81.
- Failure, failed › heart (acute) (senile) (sudden) › congestive › with rheumatic fever (conditions in I00) › inactive or quiescent (with chorea)
- Failure, failed › heart (acute) (senile) (sudden) › congestive › rheumatic (chronic) (inactive) (with chorea)
- Failure, failed › ventricular › left › with rheumatic fever (conditions in I00) › inactive or quiescent (with chorea)
- Failure, failed › ventricular › left › rheumatic (chronic) (inactive) (with chorea)
- Fever (inanition) (of unknown origin) (persistent) (with chills) (with rigor) › rheumatic (active) (acute) (chronic) (subacute) › inactive or quiescent with › heart failure (congestive) (conditions in category I50.)
- Fever (inanition) (of unknown origin) (persistent) (with chills) (with rigor) › rheumatic (active) (acute) (chronic) (subacute) › inactive or quiescent with › left ventricular failure (conditions in I50.1-I50.4-)
Codes whose notes reference I09.81
- I50Code first
MS-DRG v44.0 grouping
All DRGs →Inpatient MS-DRGs this diagnosis can group to, as the principal or a secondary diagnosis, depending on the rest of the claim.
MDC 05 · Diseases and Disorders of the Circulatory System
MDC 15 · Newborns and Other Neonates with Conditions Originating in the Perinatal Period
MDC 15 · Newborns and Other Neonates with Conditions Originating in the Perinatal Period
ICD-9-CM equivalent
Converter →- 398.91Rheumatic heart failure (congestive)exact
From the CMS 2018 General Equivalence Mappings (GEMs), the final GEMs release.
Code history
- 2016
- 2017
- 2018
- 2019
- 2020
- 2021
- 2022
- 2023
- 2024
- 2025
- 2026
- 2027
- FY2016 (effective 10/1/2015): Added (first year of ICD-10-CM)
- No changes since FY2016.
Common questions about I09.81
Is I09.81 billable?
- Yes. I09.81 is a billable/specific ICD-10-CM code valid for FY2027 (October 1, 2026 – September 30, 2027).
Can I09.81 be used as a principal diagnosis?
- Yes. The Medicare Code Editor doesn't restrict I09.81 as a principal diagnosis.
Is I09.81 a CC or MCC?
- I09.81 is a CC (complication or comorbidity) under MS-DRG v44.0, unless excluded by the principal diagnosis.
What DRG does I09.81 group to?
- I09.81 is used in the MS-DRG v44.0 logic for MS-DRG 291 (Heart Failure and Shock with MCC), MS-DRG 292 (Heart Failure and Shock with CC), MS-DRG 293 (Heart Failure and Shock without CC/MCC), MS-DRG 791 (Prematurity with Major Problems) and MS-DRG 793 (Full Term Neonate with Major Problems). Which one applies depends on whether it is the principal diagnosis and on the rest of the claim.
What is the ICD-9 code for I09.81?
- The CMS General Equivalence Mappings map I09.81 to ICD-9-CM 398.91.