I38 ICD-10-CM Code: Endocarditis, valve unspecified
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Diseases of the circulatory system (I00-I99) / Other forms of heart disease (I30-I5A)
I38
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceEndocarditis, valve unspecified
An infection and inflammation of the inner lining of the heart (endocardium) affecting one or more heart valves, but the specific valve involved is not identified.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for I38 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for I38 in this effective period.
Related Child Codes
ICD-10-CM does not list child codes under I38 for this display context.
Includes
Official- endocarditis (chronic) NOS
- valvular incompetence NOS
- valvular insufficiency NOS
- valvular regurgitation NOS
- valvular stenosis NOS
Excludes 1
Official- congenital insufficiency of cardiac valve NOS (Q24.8)
- congenital stenosis of cardiac valve NOS (Q24.8)
- endocardial fibroelastosis (I42.4)
- endocarditis specified as rheumatic (I09.1)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for I38 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for I38 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for I38 in this effective period.
Buddy Documentation Tip
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is I38 an HCC code?
No. I38 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- I38
- Description
- Endocarditis, valve unspecified
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
I38 is the ICD-10-CM diagnosis code for endocarditis, valve unspecified. An infection and inflammation of the inner lining of the heart (endocardium) affecting one or more heart valves, but the specific valve involved is not identified. I38 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).
I38 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 is a serious condition requiring identification of the causative organism when possible.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for I38 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a serious condition requiring identification of the causative organism when possible
- •Always attempt to identify which valve is affected and the infectious agent to use more specific codes
Includes
- endocarditis (chronic) NOS
- valvular incompetence NOS
- valvular insufficiency NOS
- valvular regurgitation NOS
- valvular stenosis NOS
- valvulitis (chronic) NOS