2026 ICD-10-CM Diagnosis Code I09.81Rheumatic heart failure

ICD-10-CM Codes›I00–I99›I05-I09›I09

ICD-10-CM I09.81
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

I09.81 is a billable ICD-10-CM diagnosis code for rheumatic heart failure. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 291 through 293. Coders also document this condition as chronic congestive heart failure. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Chronic rheumatic heart disease and Heart failure.

This medical diagnosis code is frequently used in Cardiology medical specialties to designate conditions such heart failure.

Code Identity

ICD-10-CM Code
I09.81
Billable Status
Yes — Valid for Submission
Code Describes
Rheumatic heart failure
Short Description
Rheumatic heart failure
Same as the full description in the CMS dataset.
Parent Code
I09.8
Other specified rheumatic heart diseases

Code Classification

ChapterI00–I99Diseases of the circulatory system
SectionI05-I09Chronic rheumatic heart diseases
CategoryI09Other rheumatic heart diseases
This CodeI09.81Rheumatic heart failure

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Chronic congestive heart failure
  • Chronic left-sided congestive heart failure
  • Chronic left-sided heart failure
  • Congestive rheumatic heart failure
  • Rheumatic left ventricular failure

Tabular List NotesGuidance

Coding notes and annotation back-references applicable to this code.

Use Additional Code

  • code to identify type of heart failure I50

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • 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-)

Clinical ClassificationClinical

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

CCSR CIR001
Chronic rheumatic heart disease
Default principal diagnosis: inpatient No · outpatient No
CCSR CIR019
Heart failure
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Heart Failure

Heart failure means that your heart can't pump enough oxygen-rich blood to meet your body's needs. Heart failure doesn't mean that your heart has stopped or is about to stop beating. But without enough blood flow, your organs may not work well, which can cause serious problems.

The full article covers:

  • What is heart failure?
  • What causes heart failure?
  • Who is more likely to develop heart failure?
  • What are the symptoms of heart failure?
  • What other problems does heart failure cause?
  • How is heart failure diagnosed?
  • What are the treatments for heart failure?
  • Can heart failure be prevented?

Read the full article at MedlinePlus

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

Convert I09.81 to ICD-9-CMHistory

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

ICD-9-CM
398.91 Rheumatic heart failure
Exact Match The mapping is direct, with no qualifiers.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About I09.81Overview

Is I09.81 (Other specified rheumatic heart diseases) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report rheumatic heart failure on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does I09.81 group to?

When rheumatic heart failure is the principal diagnosis on an inpatient stay, it groups to MS-DRG 291, 292, 293, with relative weights from 0.5660 to 1.2838 depending on complications. Higher weights mean higher Medicare reimbursement.

What is the ICD-9 equivalent of I09.81?

Under the General Equivalence Mappings, rheumatic heart failure converts to ICD-9-CM 398.91 (rheumatic heart failure). The mapping is a direct match.

Footnotes

[1] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:

  • The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
  • The condition places limitations on self-care, independent living, and social interactions.