2027 ICD-10-CM Diagnosis Code A38.1Scarlet fever with myocarditis

ICD-10-CM Codes›A00–B99›A30-A49›A38

ICD-10-CM A38.1
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

A38.1 is a billable ICD-10-CM diagnosis code for scarlet fever with myocarditis. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 867 through 869. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 8 closely related codes. Coders also document this condition as myocarditis due to scarlet fever. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Bacterial infections and Myocarditis and cardiomyopathy.

Code Identity

ICD-10-CM Code
A38.1
Billable Status
Yes — Valid for Submission
Code Describes
Scarlet fever with myocarditis
Short Description
Scarlet fever with myocarditis
Same as the full description in the CMS dataset.
Parent Code
A38
Scarlet fever

Code Classification

ChapterA00–B99Certain infectious and parasitic diseases
SectionA30-A49Other bacterial diseases
CategoryA38Scarlet fever
This CodeA38.1Scarlet fever with myocarditis

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Myocarditis due to scarlet fever

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to A38.1: its own notes plus those printed at A38 and Chapter 1. A note printed at a category, block or chapter applies to every code under it.

Includes

Further defines, or gives examples of, the content of the category.

From A38 Scarlet fever applies to 4 codes
  • scarlatina
From Chapter 1 (A00-B99) Certain infectious and parasitic diseases applies to 1,068 codes
  • diseases generally recognized as communicable or transmissible

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From A38 Scarlet fever applies to 4 codes
  • streptococcal sore throat (J02.0)
From Chapter 1 (A00-B99) Certain infectious and parasitic diseases applies to 1,068 codes
  • carrier or suspected carrier of infectious disease (Z22.-)
  • certain localized infections - see body system-related chapters
  • infectious and parasitic diseases complicating pregnancy, childbirth and the puerperium (O98.-)
  • infectious and parasitic diseases specific to the perinatal period (P35-P39)
  • influenza and other acute respiratory infections (J00-J22)

Use Additional Code

Add a second code, after this one, to fully describe the condition.

From Chapter 1 (A00-B99) Certain infectious and parasitic diseases applies to 1,068 codes
  • code to identify resistance to antimicrobial drugs (Z16.-)

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name A38.1, its category, or a range that includes it.

Excludes2 1

These codes carry an Excludes2 note naming A38.1: its condition is not part of those codes, and both may be reported when the patient has both.

  • J02.0 Streptococcal pharyngitis
    scarlet fever (A38.-) names A38.-, which includes this code

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR INF003
Bacterial infections
Default principal diagnosis: inpatient No · outpatient No
CCSR CIR005
Myocarditis and cardiomyopathy
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Scarlet Fever

    infection with group a streptococci that is characterized by tonsillitis and pharyngitis. an erythematous rash is commonly present.

Patient EducationClinical

Cardiomyopathy

Cardiomyopathy is the name for diseases of the heart muscle. These diseases enlarge your heart muscle or make it thicker and more rigid than normal. In rare cases, scar tissue replaces the muscle tissue.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert A38.1 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
034.1 Scarlet fever
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About A38.1Overview

What is the ICD-10 code for scarlet fever with myocarditis?

The ICD-10-CM code for scarlet fever with myocarditis is A38.1 (sometimes written as A381). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is A38.1 (Scarlet fever) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report scarlet fever with myocarditis on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does A38.1 group to?

When scarlet fever with myocarditis is the principal diagnosis on an inpatient stay, it groups to MS-DRG 867, 869, 868, with relative weights from 0.6784 to 2.1855 depending on complications. Higher weights mean higher Medicare reimbursement.

Is A38.1 a CC or MCC?

CMS lists A38.1 as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 8 closely related codes in its exclusion list.

What is the ICD-9 equivalent of A38.1?

Under the General Equivalence Mappings, scarlet fever with myocarditis converts to ICD-9-CM 034.1 (scarlet fever). The mapping is approximate, so confirm the match fits the documentation.