Question 1

What is ICD-10 code I32?

Accepted Answer

I32 is the ICD-10-CM diagnosis code for pericarditis in diseases classified elsewhere. Inflammation of the heart's outer lining that occurs as a complication of another disease or condition documented in the medical record. I32 sits in the ICD-10-CM chapter for diseases of the circulatory system (i00-i99), within the section covering other forms of heart disease (i30-i5a).

I32 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

This code requires a secondary diagnosis code for the underlying disease causing the pericarditis.

Question 2

Is I32 an HCC code?

Accepted Answer

No. I32 is a billable ICD-10-CM code but does not map to any payment HCC category under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can still be reported on Medicare Advantage encounter data submissions, but it does not contribute to the beneficiary's Risk Adjustment Factor (RAF) score and therefore does not affect the risk-adjusted capitation payment to the plan. V28 reached 100% phase-in for payment year 2026.

Question 3

Is I32 billable?

Accepted Answer

Yes. I32 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. I32 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Question 4

What is the V28 vs V24 difference for I32?

Accepted Answer

I32 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither community model rewards I32 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's V28/V24 community RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a community payment HCC.

Question 5

What should coders know when reporting I32?

Accepted Answer

This code requires a secondary diagnosis code for the underlying disease causing the pericarditis Always sequence the underlying disease first, followed by I32 as the manifestation

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I32

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I32 ICD-10-CM Code: Pericarditis in diseases classified elsewhere

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I32

Is I32 an HCC code?

Get the V28 RAF + MEAT cheat sheet

What This Code Means

Coding Tips

Excludes 1, Do NOT code together

Code First

Code Hierarchy

Work I32 in HCC Buddy