ICD-10 Coding for Aortic Valve Disease(I35.0, I35.1, Q23.81)
Complete ICD-10-CM coding and documentation guide for Aortic Valve Disease. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Aortic Valve Disease
I35-I38Primary Range
Nonrheumatic valve disorders
Covers nonrheumatic aortic valve diseases including stenosis and insufficiency.
Congenital malformations of aortic valve
Includes congenital conditions like 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 stenosis | Use when aortic stenosis is nonrheumatic and confirmed by imaging. |
|
| I35.1 | Nonrheumatic aortic insufficiency | Use for nonrheumatic aortic regurgitation confirmed by echo. |
|
| Q23.81 | Bicuspid aortic valve | Use when bicuspid aortic valve is confirmed as congenital. |
|
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 nonrheumatic aortic stenosis
Essential facts and insights about Aortic Valve Disease
Primary ICD-10-CM Codes for aortic valve disease
Decision Criteria
clinical Criteria
- Nonrheumatic etiology confirmed by imaging and clinical history.
Applicable To
- Calcific aortic stenosis
- Senile aortic stenosis
Excludes
- Rheumatic aortic stenosis (I06.0)
Clinical Validation Requirements
- Echocardiogram showing valve area <1.0 cm²
- Peak gradient >40 mmHg
Code-Specific Risks
- Misclassification if rheumatic origin is not ruled out.
Coding Notes
- Ensure documentation specifies nonrheumatic etiology.
I35.1 - Nonrheumatic aortic insufficiency
Use for nonrheumatic aortic regurgitation confirmed by echo.
Applicable To
- Aortic regurgitation
Excludes
- Rheumatic aortic insufficiency (I06.1)
Clinical Validation Requirements
- Doppler echocardiogram showing regurgitant volume ≥60 mL
Coding Notes
Document the nonrheumatic nature explicitly.
Q23.81 - Bicuspid aortic valve
Use when bicuspid aortic valve is confirmed as congenital.
Applicable To
- Congenital bicuspid aortic valve
Excludes
- Acquired aortic stenosis (I35.0)
Clinical Validation Requirements
- Echocardiogram or MRI confirming bicuspid morphology
Coding Notes
Always document congenital nature and any associated conditions.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Heart failure, unspecified
I50.9Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Aortic Valve Disease to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I35.0.
Impact
Clinical: Missed congenital diagnosis affecting treatment., Regulatory: Non-compliance with coding guidelines., Financial: Potential loss of reimbursement for congenital conditions.
Mitigation Strategy
Review echocardiogram for congenital anomalies, Include congenital status in documentation
Impact
Reimbursement: Potential for reduced reimbursement due to lack of specificity., Compliance: Increased risk of audit due to unspecified coding., Data Quality: Decreased data accuracy for clinical outcomes.
Mitigation Strategy
Ensure documentation specifies etiology and severity.
Impact
Use of unspecified codes increases audit risk.
Mitigation Strategy
Ensure detailed documentation and specific coding.
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 Valve Disease, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Aortic Valve Disease
Use these documentation templates to ensure complete and accurate documentation for Aortic Valve Disease. These templates include all required elements for proper coding and billing.
Aortic Valve Replacement
Specialty: CardiologyRequired Elements
- Etiology of valve disease
- Severity of stenosis or regurgitation
- Procedure details
- Post-operative care
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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