ICD-10 Coding for Nonrheumatic Mitral Valve Regurgitation(I34.0, I34.1)
Complete ICD-10-CM coding and documentation guide for Nonrheumatic Mitral Valve Regurgitation. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Nonrheumatic Mitral Valve Regurgitation
I34-I38Primary Range
Nonrheumatic mitral valve disorders
This range includes codes for nonrheumatic mitral valve disorders, specifically focusing on mitral regurgitation without rheumatic origin.
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 regurgitation is confirmed as nonrheumatic and isolated to the mitral valve. |
|
| I34.1 | Mitral valve prolapse | Use when mitral valve prolapse is documented with or without regurgitation. |
|
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 valve regurgitation
Essential facts and insights about Nonrheumatic Mitral Valve Regurgitation
Primary ICD-10-CM Codes for nonrheumatic mitral valve regurgitation
Decision Criteria
clinical Criteria
- Echocardiogram shows nonrheumatic features
documentation Criteria
- Explicit mention of 'nonrheumatic' in the medical record
Applicable To
- Nonrheumatic mitral valve regurgitation
Excludes
- Rheumatic mitral valve disorders (I05.-)
Clinical Validation Requirements
- Echocardiogram showing mitral regurgitation without rheumatic features
- Documentation specifying 'nonrheumatic'
Code-Specific Risks
- Misclassification if multiple valves are involved without clear documentation.
Coding Notes
- Ensure documentation explicitly states 'nonrheumatic' to avoid defaulting to rheumatic codes.
I34.1 - Mitral valve prolapse
Use when mitral valve prolapse is documented with or without regurgitation.
Applicable To
- Mitral valve prolapse with regurgitation
Excludes
- Rheumatic mitral valve disorders (I05.-)
Clinical Validation Requirements
- Echocardiogram showing leaflet displacement >2mm
- Documentation of prolapse
Coding Notes
Ensure prolapse is documented as nonrheumatic.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Encounter for examination for normal comparison and control in clinical research program
Z00.6Differential 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 Nonrheumatic Mitral Valve Regurgitation to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I34.0.
Impact
Clinical: Misclassification of the condition., Regulatory: Potential audit issues., Financial: Incorrect DRG assignment affecting reimbursement.
Mitigation Strategy
Educate providers on the importance of specifying etiology., Use templates that prompt for etiology.
Impact
Reimbursement: Incorrect DRG assignment leading to potential reimbursement issues., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Ensure documentation specifies 'nonrheumatic' and check for involvement of other valves.
Impact
Risk of audits due to lack of specificity in documenting nonrheumatic etiology.
Mitigation Strategy
Implement documentation templates that require etiology specification.
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 Nonrheumatic Mitral Valve Regurgitation, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Nonrheumatic Mitral Valve Regurgitation
Use these documentation templates to ensure complete and accurate documentation for Nonrheumatic Mitral Valve Regurgitation. These templates include all required elements for proper coding and billing.
Cardiology Progress Note
Specialty: CardiologyRequired Elements
- Etiology
- Severity
- Symptoms
- Imaging results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Nonrheumatic Mitral Valve Regurgitation? Ask your questions below.