ICD-10 · PDGM grouping
I31 Other diseases of pericardium
All 8 codes in the I31 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
Codes in family
8
Can lead a claim
6
Cannot lead a claim
2
What CMS assigns to I31
6 of the 8 codes group to MMTA - Cardiac and Circulatory; 2 are assigned no clinical group. None of the 8 is assigned a comorbidity subgroup. 6 of the 8 can lead a claim. CMS attaches a code-first note to 2 of the 8.
Code first
CMS grouper convention 9, on I31.31. Code first:
- neoplasm (C00-D49)
CMS grouper convention 12, on I31.4. Code first:
- underlying disease
Every code in I31
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| I31.0 | Chronic adhesive pericarditis | Can lead a claim | H | None |
| I31.1 | Chronic constrictive pericarditis | Can lead a claim | H | None |
| I31.2 | Hemopericardium, not elsewhere classified | Can lead a claim | H | None |
| I31.3 Pericardial effusion (noninflammatory) | ||||
| I31.31 | Malignant pericardial effusion in diseases classified elsewhereCMS: Malignant pericardial effusion in diseases classd elswhr | Cannot lead a claimManifestation code is not reportable as principal diagnosis | None | None |
| I31.39 | Other pericardial effusion (noninflammatory) | Can lead a claim | H | None |
| I31.4 | Cardiac tamponade | Cannot lead a claimUnacceptable principal diagnosis, code is not reportable as principal diagnosis | None | None |
| I31.8 | Other specified diseases of pericardium | Can lead a claim | H | None |
| I31.9 | Disease of pericardium, unspecified | Can lead a claim | H | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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