ICD-10 Coding for Aortic Valve Replacement(I35.0, Z95.2)
Complete ICD-10-CM coding and documentation guide for Aortic Valve Replacement. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Aortic Valve Replacement
I35-I38Primary Range
Diseases of aortic valve
This range includes conditions related to aortic valve disorders, which are often the underlying reason for aortic valve replacement.
Presence of prosthetic heart valve
Used to indicate the presence of a prosthetic valve post-replacement.
Complications of cardiac and vascular prosthetic devices, implants and grafts
Covers complications that may arise from the prosthetic 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 the primary reason for valve replacement. |
|
| Z95.2 | Presence of prosthetic heart valve | Use to indicate the presence of a prosthetic valve after replacement surgery. |
|
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 valve replacement
Essential facts and insights about Aortic Valve Replacement
Primary ICD-10-CM Codes for aortic valve replacement
Decision Criteria
clinical Criteria
- Echocardiogram confirms severe stenosis
documentation Criteria
- MDT assessment documented
Applicable To
- Aortic stenosis
Excludes
- Rheumatic aortic stenosis (I06.0)
Clinical Validation Requirements
- Echocardiogram showing AVA ≤1.0 cm²
- Mean gradient ≥40 mmHg
Code-Specific Risks
- Ensure accurate echocardiographic measurements are documented.
Coding Notes
- Ensure to document the specific type of valve and approach used.
Z95.2 - Presence of prosthetic heart valve
Use to indicate the presence of a prosthetic valve after replacement surgery.
Applicable To
- Presence of artificial heart valve
Excludes
- Complications of heart valve prosthesis (T82.0-T82.9)
Clinical Validation Requirements
- Surgical report confirming valve replacement
Coding Notes
Always used in conjunction with the condition that necessitated the replacement.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Presence of prosthetic heart valve
Z95.2Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Nonrheumatic aortic (valve) insufficiency
I35.1Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Aortic Valve Replacement to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I35.0.
Impact
Clinical: Inadequate information for future care decisions., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials or reduced reimbursement.
Mitigation Strategy
Use standardized templates for operative notes, Ensure all team members review documentation
Impact
Reimbursement: Incorrect sequencing may lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Impacts the accuracy of patient records.
Mitigation Strategy
Always sequence the underlying condition first, followed by Z95.2.
Impact
Failure to document MDT decisions can lead to audit issues.
Mitigation Strategy
Implement mandatory MDT documentation protocols.
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 Replacement, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Aortic Valve Replacement
Use these documentation templates to ensure complete and accurate documentation for Aortic Valve Replacement. These templates include all required elements for proper coding and billing.
TAVR with Complication
Specialty: CardiologyRequired Elements
- Procedure approach
- Valve type and size
- Complications encountered
- MDT involvement
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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