ICD-10 Coding for Aortic Stenosis(I35.0, I06.0, Q23.1)
Complete ICD-10-CM coding and documentation guide for Aortic Stenosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Aortic Stenosis
I35-I38Primary Range
Diseases of aortic valve
This range includes codes for various aortic valve diseases, including nonrheumatic aortic stenosis.
Rheumatic heart diseases
This range includes codes for rheumatic aortic stenosis and multivalvular involvement.
Congenital malformations of aortic valve
This range includes codes for congenital aortic stenosis, such as bicuspid aortic valve.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I35.0 | Nonrheumatic aortic (valve) stenosis | Use when aortic stenosis is confirmed as nonrheumatic. |
|
| I06.0 | Rheumatic aortic stenosis | Use when aortic stenosis is confirmed as rheumatic. |
|
| Q23.1 | Congenital stenosis of aortic valve | Use for congenital aortic stenosis, such as bicuspid valve. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for aortic stenosis
Essential facts and insights about Aortic Stenosis
Primary ICD-10-CM Codes for aortic stenosis
Decision Criteria
clinical Criteria
- Echocardiographic evidence of stenosis severity
documentation Criteria
- Explicit mention of nonrheumatic origin
Applicable To
- Calcific aortic stenosis
Excludes
- Rheumatic aortic stenosis (I06.0)
Clinical Validation Requirements
- Echocardiography showing AVA <1.0 cm²
- Peak velocity ≥4.0 m/s
Code-Specific Risks
- Misclassification if rheumatic origin is not ruled out
Coding Notes
- Ensure documentation specifies nonrheumatic etiology.
I06.0 - Rheumatic aortic stenosis
Use when aortic stenosis is confirmed as rheumatic.
Applicable To
- Rheumatic aortic valve stenosis
Excludes
- Nonrheumatic aortic stenosis (I35.0)
Clinical Validation Requirements
- History of rheumatic fever
- Echocardiography showing commissural fusion
Coding Notes
Document rheumatic history clearly.
Q23.1 - Congenital stenosis of aortic valve
Use for congenital aortic stenosis, such as bicuspid valve.
Applicable To
- Bicuspid aortic valve
Excludes
- Acquired aortic stenosis (I35.0)
Clinical Validation Requirements
- Congenital diagnosis confirmed by echocardiography
Coding Notes
Ensure congenital nature is documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Aortic Stenosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I35.0.
Impact
Clinical: Leads to inappropriate treatment plans., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims due to lack of specificity.
Mitigation Strategy
Use specific terms for etiology and severity, Ensure echocardiographic data is included
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate clinical data and reporting.
Mitigation Strategy
Use Q23.1 for congenital cases and I35.0 if acquired stenosis develops.
Impact
Reimbursement: Potential underpayment due to incomplete coding., Compliance: Failure to comply with coding standards., Data Quality: Incomplete representation of patient's condition.
Mitigation Strategy
Use I08.x when both aortic and mitral valves are involved.
Impact
Failure to document etiology can lead to incorrect coding.
Mitigation Strategy
Implement mandatory fields for etiology in EHR templates.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Aortic Stenosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Aortic Stenosis
Use these documentation templates to ensure complete and accurate documentation for Aortic Stenosis. These templates include all required elements for proper coding and billing.
Aortic Stenosis Evaluation
Specialty: CardiologyRequired Elements
- Etiology of stenosis
- Severity assessment
- Echocardiographic findings
- Associated symptoms
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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