ICD-10 Coding for Heart Valve Disease(I34.0, I35.0)
Complete ICD-10-CM coding and documentation guide for Heart Valve Disease. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Heart Valve Disease
I34-I38Primary Range
Non-rheumatic heart valve disorders
Primary range for non-rheumatic heart valve diseases.
Congenital malformations of cardiac valves
Includes congenital anomalies 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 |
|---|---|---|---|
| I34.0 | Nonrheumatic mitral (valve) insufficiency | Use when mitral insufficiency is confirmed without rheumatic history. |
|
| I35.0 | Nonrheumatic aortic (valve) stenosis | Use for confirmed non-rheumatic aortic stenosis. |
|
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: How to code bicuspid aortic valve with stenosis
Essential facts and insights about Heart Valve Disease
Primary ICD-10-CM Codes for heart valve disease
Decision Criteria
clinical Criteria
- Echocardiogram findings of mitral valve insufficiency
Applicable To
- Mitral valve prolapse
Excludes
- Rheumatic mitral valve disorders (I05.-)
Clinical Validation Requirements
- Echocardiogram showing regurgitant volume ≥60 mL/beat
Code-Specific Risks
- Misclassification as rheumatic if history is unclear.
Coding Notes
- Ensure clear documentation of non-rheumatic etiology.
I35.0 - Nonrheumatic aortic (valve) stenosis
Use for confirmed non-rheumatic aortic stenosis.
Applicable To
- Calcific aortic stenosis
Excludes
- Rheumatic aortic valve disorders (I06.-)
Clinical Validation Requirements
- Echocardiogram showing valve area ≤1.0 cm²
Coding Notes
Document echocardiogram findings clearly.
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 Heart Valve Disease to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I34.0.
Impact
Clinical: Inadequate treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential loss of reimbursement.
Mitigation Strategy
Use standardized templates., Ensure complete echocardiogram documentation.
Impact
Reimbursement: May lead to reduced reimbursement., Compliance: Increases risk of audit., Data Quality: Compromises data accuracy.
Mitigation Strategy
Ensure detailed documentation to select specific codes.
Impact
High risk of audit for unspecified codes.
Mitigation Strategy
Ensure detailed documentation and specific code selection.
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 Heart Valve Disease, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Heart Valve Disease
Use these documentation templates to ensure complete and accurate documentation for Heart Valve Disease. These templates include all required elements for proper coding and billing.
Nonrheumatic Aortic Stenosis
Specialty: CardiologyRequired Elements
- Etiology
- Valve Involved
- Severity
- Symptoms
- Imaging
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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