ICD-10 Coding for Aortic Valve Disorder(I35.0, I35.1, I35.2, I35.9)
Complete ICD-10-CM coding and documentation guide for Aortic Valve Disorder. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Aortic Valve Disorder
I35.0-I35.9Primary Range
Nonrheumatic aortic valve disorders
This range includes all nonrheumatic aortic valve disorders, which are the primary focus for coding aortic valve conditions.
Congenital malformations of aortic and mitral valves
This range includes congenital conditions such as bicuspid aortic valve, which may coexist with nonrheumatic disorders.
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 echocardiographic findings confirm severe stenosis. |
|
| I35.1 | Nonrheumatic aortic (valve) insufficiency | Use when echocardiographic findings confirm significant regurgitation. |
|
| I35.2 | Nonrheumatic aortic (valve) stenosis with insufficiency | Use when both stenosis and regurgitation are documented. |
|
| I35.9 | Nonrheumatic aortic valve disorder, unspecified | Use only when specific details are unavailable. |
|
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 Valve Disorder
Primary ICD-10-CM Codes for aortic valve disorder
Decision Criteria
clinical Criteria
- Severe stenosis confirmed by echocardiography
Applicable To
- Calcific aortic stenosis
Excludes
- Rheumatic aortic stenosis (I06.0)
Clinical Validation Requirements
- Peak velocity ≥4.0 m/s
- Mean gradient ≥40 mmHg
- Aortic valve area ≤1.0 cm²
Code-Specific Risks
- Misclassification if severity is not documented
Coding Notes
- Ensure documentation specifies nonrheumatic etiology.
I35.1 - Nonrheumatic aortic (valve) insufficiency
Use when echocardiographic findings confirm significant regurgitation.
Applicable To
- Aortic regurgitation
Excludes
- Rheumatic aortic insufficiency (I06.1)
Clinical Validation Requirements
- Vena contracta ≥0.6 cm
- Regurgitant volume ≥60 mL/beat
Coding Notes
Document the severity and etiology clearly.
I35.2 - Nonrheumatic aortic (valve) stenosis with insufficiency
Use when both stenosis and regurgitation are documented.
Applicable To
- Mixed aortic valve disease
Excludes
- Rheumatic aortic stenosis with insufficiency (I06.2)
Clinical Validation Requirements
- Combination of stenosis and regurgitation criteria
Coding Notes
Ensure both stenosis and insufficiency are documented.
I35.9 - Nonrheumatic aortic valve disorder, unspecified
Use only when specific details are unavailable.
Excludes
- Rheumatic aortic valve disorder (I06.x)
Clinical Validation Requirements
- Lack of specific echocardiographic findings
Coding Notes
Avoid using unless absolutely necessary.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Congenital aortic stenosis
Q23.1Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Rheumatic aortic stenosis
I06.0Rheumatic aortic insufficiency
I06.1Rheumatic aortic stenosis with insufficiency
I06.2Rheumatic aortic valve disorders
I06.xDocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Aortic Valve Disorder to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I35.0.
Impact
Clinical: May lead to inappropriate treatment decisions., Regulatory: Non-compliance with documentation standards., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Train staff on documentation requirements, Use templates for specific conditions
Impact
Reimbursement: May lead to lower reimbursement due to lack of specificity., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Ensure documentation specifies stenosis, insufficiency, or both.
Impact
Reimbursement: Potential loss of reimbursement for congenital conditions., Compliance: Non-compliance with coding standards., Data Quality: Inaccurate representation of patient condition.
Mitigation Strategy
Add Q23.83 when congenital bicuspid valve is documented.
Impact
Frequent use of unspecified codes can trigger audits.
Mitigation Strategy
Ensure detailed documentation to support 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 Disorder, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Aortic Valve Disorder
Use these documentation templates to ensure complete and accurate documentation for Aortic Valve Disorder. These templates include all required elements for proper coding and billing.
Severe aortic stenosis
Specialty: CardiologyRequired Elements
- Peak velocity
- Mean gradient
- Aortic valve area
- Symptoms
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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