ICD-10 Coding for Mitral Valve Insufficiency(I34.0)
Complete ICD-10-CM coding and documentation guide for Mitral Valve Insufficiency. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Mitral Valve Insufficiency
Key Information: ICD-10 code for mitral valve insufficiency
Essential facts and insights about Mitral Valve Insufficiency
Primary ICD-10-CM Code for mitral valve insufficiency
Decision Criteria
clinical Criteria
- Presence of nonrheumatic mitral valve insufficiency confirmed by echocardiogram.
documentation Criteria
- Documentation must specify 'nonrheumatic' to use I34.0.
Applicable To
- Mitral regurgitation NOS
- Mitral incompetence NOS
Excludes
- Rheumatic mitral insufficiency (I05.1)
Clinical Validation Requirements
- Echocardiogram showing regurgitant volume ≥60 mL/beat
- Vena contracta ≥0.7 cm
- EROA ≥0.4 cm²
Code-Specific Risks
- Incorrectly assuming rheumatic origin without documentation
Coding Notes
- Ensure documentation specifies nonrheumatic origin to avoid miscoding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Heart failure
I50.-Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Rheumatic mitral insufficiency
I05.1Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Mitral Valve Insufficiency to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I34.0.
Impact
Clinical: Leads to incorrect treatment plans based on assumed etiology., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials due to incorrect coding.
Mitigation Strategy
Ensure thorough documentation of etiology, Use queries to clarify unspecified etiology
Impact
Reimbursement: Potential denial of claims due to incorrect coding., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Query for clarification on etiology if not specified.
Impact
Failure to document etiology can lead to incorrect coding and audit findings.
Mitigation Strategy
Implement routine documentation checks to ensure etiology is specified.
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 Valve Insufficiency, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Mitral Valve Insufficiency
Use these documentation templates to ensure complete and accurate documentation for Mitral Valve Insufficiency. These templates include all required elements for proper coding and billing.
Cardiology Progress Note
Specialty: CardiologyRequired Elements
- Patient symptoms
- Echocardiogram findings
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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