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Acute rheumatic fever G043

Document
Last amended 
30 June 2015

Current RMA Instruments:

Reasonable Hypothesis SOP23 of 2011
Balance of Probabilities SOP24 of 2011
Changes from Previous Instruments:

SOP Bulletin 149

ICD Coding:
  • ICD-9-CM Codes: 390,391.0,391.2,391.8,391.9,392.0,392.9
  • ICD-10-AM Codes: I00, I01, I02

Acute rheumatic fever is a now rare autoimmune disease that may develop within a few weeks following a specific streptococcal throat infection. It causes inflammation of the joints, heart, skin and brain. Chronic damage to the heart, particularly the heart valves, that may arise following this illness, is covered by the rheumatic heart disease SOP.

Is specific diagnostic evidence required to apply the SOP?No.
Are there sub-factors that require specific information? – No.
Additional diagnoses covered by SOP
  • Recurrent acute rheumatic fever
  • Acute rheumatic carditis
Conditions not covered by SOP
  • rheumatic heart disease, ICD9 codes 393-8
  • rheumatic aortic valve incompetence or stenosis, ICD9 code 395
  • rheumatic mitral valve incompetence or stenosis, ICD9 code 394
  • rheumatic pulmonary valve disease, ICD9 code 397.1
  • rheumatic tricuspid valve incompetence or stenosis, ICD9 code 397.0
  • chronic rheumatic myocarditis, ICD9 code 398.0
  • chronic rheumatic pericarditis, ICD9 code 393
Unconfirmed diagnosis

If, after applying the above information, you are unable to confirm the diagnosis, you should then:

  1. seek medical officer advice about further investigation, or;
  2. generate a diagnostic report, or;
  3. re-encode the condition, if appropriate.

The following investigations may be useful in establishing the diagnosis.

  • Report from cardiologist
  • Report on serology for Group A streptococcal infection