ICD-10 Coding for Endocarditis of Aortic Valve(I33.0, I35.1, T82.6XXA)
Complete ICD-10-CM coding and documentation guide for Endocarditis of Aortic Valve. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Endocarditis of Aortic Valve
I33-I39Primary Range
Endocarditis and Heart Valve Disorders
This range includes codes for endocarditis and related heart valve disorders, specifically addressing the aortic valve.
Bacterial and Viral Infectious Agents
These codes are used to specify the infectious organism causing the endocarditis.
Complications of Cardiac Valve Prosthesis
This range is relevant for coding complications related to prosthetic heart valves, including endocarditis.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I33.0 | Acute and subacute infective endocarditis | Use when acute or subacute infective endocarditis is diagnosed, particularly involving the aortic valve. |
|
| I35.1 | Nonrheumatic aortic (valve) insufficiency | Use when aortic insufficiency is a result of endocarditis. |
|
| T82.6XXA | Mechanical complication of cardiac valve prosthesis, initial encounter | Use when endocarditis involves a prosthetic 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 valve endocarditis
Essential facts and insights about Endocarditis of Aortic Valve
Primary ICD-10-CM Codes for endocarditis of aortic valve
Decision Criteria
clinical Criteria
- Presence of vegetation on echocardiogram and positive blood cultures
Applicable To
- Acute infective endocarditis
- Subacute infective endocarditis
Excludes
- Chronic rheumatic endocarditis (I09.1)
Clinical Validation Requirements
- Positive blood cultures
- Echocardiographic evidence of vegetation or abscess
Code-Specific Risks
- Misclassification if valve involvement is not specified
- Omission of organism code
Coding Notes
- Ensure documentation specifies the aortic valve and the causative organism.
I35.1 - Nonrheumatic aortic (valve) insufficiency
Use when aortic insufficiency is a result of endocarditis.
Applicable To
- Aortic regurgitation due to endocarditis
Excludes
- Rheumatic aortic insufficiency (I06.1)
Clinical Validation Requirements
- Echocardiographic evidence of aortic insufficiency
Coding Notes
Ensure the nonrheumatic nature of the insufficiency is documented.
T82.6XXA - Mechanical complication of cardiac valve prosthesis, initial encounter
Use when endocarditis involves a prosthetic valve.
Applicable To
- Prosthetic valve endocarditis
Clinical Validation Requirements
- Evidence of prosthetic valve dysfunction
- Echocardiographic findings
Coding Notes
Document the specific complication and the prosthetic nature of the valve.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Staphylococcus aureus as the cause of diseases classified elsewhere
B95.2Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Endocarditis of Aortic Valve to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I33.0.
Impact
Clinical: May lead to inappropriate treatment, Regulatory: Non-compliance with coding standards, Financial: Potential for reduced reimbursement
Mitigation Strategy
Always specify valve in clinical documentation, Use echocardiogram reports to confirm
Impact
Reimbursement: Potential underpayment due to unspecified coding, Compliance: Non-compliance with specificity requirements, Data Quality: Reduced accuracy in clinical data
Mitigation Strategy
Ensure the specific valve involved is documented and coded appropriately.
Impact
Reimbursement: May affect DRG assignment and reimbursement, Compliance: Failure to meet coding guidelines, Data Quality: Incomplete clinical data representation
Mitigation Strategy
Always include the organism code (B95-B97) when cultures identify a causative agent.
Impact
Audits may focus on whether the specific valve involved in endocarditis is documented.
Mitigation Strategy
Ensure all clinical documentation specifies the valve involved.
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 Endocarditis of Aortic Valve, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Endocarditis of Aortic Valve
Use these documentation templates to ensure complete and accurate documentation for Endocarditis of Aortic Valve. These templates include all required elements for proper coding and billing.
Acute Aortic Valve Endocarditis
Specialty: CardiologyRequired Elements
- Chief complaint
- Physical exam findings
- Laboratory results
- Imaging studies
- Final assessment
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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