ICD-10 Coding for Mitral Stenosis(I34.2, I05.0, Q23.2)
Complete ICD-10-CM coding and documentation guide for Mitral Stenosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Mitral Stenosis
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I34.2 | Nonrheumatic mitral stenosis | Use when mitral stenosis is confirmed as nonrheumatic. |
|
| I05.0 | Rheumatic mitral stenosis | Use when mitral stenosis is confirmed as rheumatic. |
|
| Q23.2 | Congenital mitral stenosis | Use for congenital cases identified at birth or in early childhood. |
|
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 mitral stenosis
Essential facts and insights about Mitral Stenosis
Primary ICD-10-CM Codes for mitral stenosis
Decision Criteria
clinical Criteria
- Echo findings consistent with nonrheumatic stenosis.
documentation Criteria
- Absence of rheumatic history in patient records.
Applicable To
- Calcific mitral stenosis
- Degenerative mitral stenosis
Clinical Validation Requirements
- Echo report showing valve area ≤1.5 cm²
- Mean gradient ≥5 mmHg
- No rheumatic stigmata
Code-Specific Risks
- Misclassification if rheumatic history is not ruled out.
Coding Notes
- Ensure documentation specifies nonrheumatic origin.
I05.0 - Rheumatic mitral stenosis
Use when mitral stenosis is confirmed as rheumatic.
Applicable To
- Post-streptococcal mitral stenosis
Excludes
- Nonrheumatic mitral stenosis (I34.2)
- Congenital mitral stenosis (Q23.2)
Clinical Validation Requirements
- Positive ASO titer
- Echo showing commissural fusion
Coding Notes
Document rheumatic history clearly.
Q23.2 - Congenital mitral stenosis
Use for congenital cases identified at birth or in early childhood.
Applicable To
- Parachute mitral valve
Excludes
- Nonrheumatic mitral stenosis (I34.2)
- Rheumatic mitral stenosis (I05.0)
Clinical Validation Requirements
- Pediatric echo showing congenital anomaly
Coding Notes
Ensure congenital nature is documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential 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 Mitral Stenosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I34.2.
Impact
Clinical: Leads to incorrect treatment plans., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Always specify etiology in clinical notes., Use templates to ensure completeness.
Impact
Reimbursement: Incorrect reimbursement due to misclassification., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Verify rheumatic history and use I05.0 if applicable.
Impact
Reimbursement: Potential denial of claims., Compliance: Violation of coding exclusivity rules., Data Quality: Confusion in clinical data interpretation.
Mitigation Strategy
Use I08.0 exclusively for rheumatic multivalvular disease.
Impact
Failure to document etiology can lead to incorrect coding.
Mitigation Strategy
Implement mandatory fields in EHR for etiology.
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 Mitral Stenosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Mitral Stenosis
Use these documentation templates to ensure complete and accurate documentation for Mitral Stenosis. These templates include all required elements for proper coding and billing.
Nonrheumatic mitral stenosis with heart failure
Specialty: CardiologyRequired Elements
- Echo findings
- Heart failure symptoms
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Mitral Stenosis? Ask your questions below.