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Rheumatic Heart Disease G008

Document
Last amended 
26 June 2015
Current RMA Instruments:
Reasonable Hypothesis SOP
19 of 2011
Balance of Probabilities SOP
20 of 2011
Changes from Previous Instruments:

SOP Bulletin 149

ICD Coding:
  • ICD-9-CM Codes: 393 - 398
  • ICD-10-AM Codes: I05, I06, I07, I08, I09

Rheumatic heart disease is chronic damage to the heart, particularly heart valves, due to acute rheumatic fever in the past.

Is specific diagnostic evidence required to apply the SOP? – No.
Are there sub-factors that require specific information? – No. 
Additional diagnoses covered by SOP
  • rheumatic aortic valve incompetence or stenosis
  • rheumatic mitral valve incompetence or stenosis
  • rheumatic pulmonary valve disease
  • rheumatic tricuspid valve incompetence or stenosis
  • chronic rheumatic myocarditis
  • chronic rheumatic pericarditis
Conditions not covered by SOP
  • Acute rheumatic fever, ICD9 codes 390-2
  • Acute rheumatic carditis, ICD9 code 391
  • Recurrent acute rheumatic fever, ICD9 codes 390-2
  • Any heart valve disease not due to past rheumatic fever, e.g.:
    • non-rheumatic aortic stenosis, ICD9 code 424.1
    • non-rheumatic mitral incompetence, ICD9 code 424.0
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 of echocardiogram
  • Report from cardiologist