ICD-10 Coding for Transcatheter Aortic Valve Replacement(Z95.2, I35.0, T82.03XA)
Complete ICD-10-CM coding and documentation guide for Transcatheter Aortic Valve Replacement. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Transcatheter Aortic Valve Replacement
Z95-Z99Primary Range
Presence of other devices
Includes codes for the presence of prosthetic heart valves, which is relevant for post-TAVR status.
Nonrheumatic aortic valve disorders
Includes codes for aortic stenosis, which is a common indication for TAVR.
Complications of cardiac and vascular prosthetic devices, implants and grafts
Includes codes for complications related to prosthetic heart valves, such as leakage or infection.
ICD-10-PCS codes for replacement of aortic valve
Includes procedural codes for TAVR, specifying the approach and device used.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| Z95.2 | Presence of prosthetic heart valve | Use for patients with a history of TAVR, indicating the presence of a prosthetic valve. |
|
| I35.0 | Nonrheumatic aortic (valve) stenosis | Use when documenting the underlying condition that necessitated TAVR. |
|
| T82.03XA | Leakage of heart valve prosthesis, initial encounter | Use when there is documented leakage of the prosthetic valve post-TAVR. |
|
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 transcatheter aortic valve replacement
Essential facts and insights about Transcatheter Aortic Valve Replacement
Primary ICD-10-CM Codes for transcatheter aortic valve replacement
Decision Criteria
clinical Criteria
- Presence of a prosthetic valve without complications.
Clinical Validation Requirements
- Documented presence of a prosthetic aortic valve post-TAVR.
Code-Specific Risks
- Ensure no active complications are present when using this code alone.
Coding Notes
- Always verify the absence of complications before coding solely with Z95.2.
I35.0 - Nonrheumatic aortic (valve) stenosis
Use when documenting the underlying condition that necessitated TAVR.
Applicable To
- Aortic stenosis due to calcification
Excludes
- Rheumatic aortic stenosis (I06.0)
Clinical Validation Requirements
- Echocardiogram showing aortic valve area <1.0 cm².
Coding Notes
Ensure echocardiographic evidence supports the diagnosis.
T82.03XA - Leakage of heart valve prosthesis, initial encounter
Use when there is documented leakage of the prosthetic valve post-TAVR.
Applicable To
- Paravalvular leak post-TAVR
Clinical Validation Requirements
- Imaging evidence of leakage around the prosthetic valve.
Coding Notes
Document the nature and extent of the leakage clearly.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Leakage of heart valve prosthesis, initial encounter
T82.03XADifferential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Rheumatic aortic stenosis
I06.0Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Transcatheter Aortic Valve Replacement to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z95.2.
Impact
Clinical: Inaccurate tracking of procedural outcomes., Regulatory: Non-compliance with CMS requirements., Financial: Potential denial of claims due to missing documentation.
Mitigation Strategy
Ensure TVT registry number is included in the documentation., Verify all registry-related documentation is complete before submission.
Impact
Reimbursement: Claims may be denied or underpaid., Compliance: Non-compliance with CMS billing rules., Data Quality: Inaccurate representation of the surgical team involved.
Mitigation Strategy
Use modifier 62 when two surgeons are involved in the procedure.
Impact
Reimbursement: Incorrect DRG assignment leading to payment discrepancies., Compliance: Failure to meet documentation standards., Data Quality: Inaccurate procedural data.
Mitigation Strategy
Specify the access route using the correct ICD-10-PCS code.
Impact
Failure to document comprehensive Heart Team evaluations can lead to audit flags.
Mitigation Strategy
Ensure all team members' evaluations are documented with dates and conclusions.
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 Transcatheter Aortic Valve Replacement, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Transcatheter Aortic Valve Replacement
Use these documentation templates to ensure complete and accurate documentation for Transcatheter Aortic Valve Replacement. These templates include all required elements for proper coding and billing.
Standard TAVR Procedure
Specialty: CardiologyRequired Elements
- Indication for procedure
- Heart Team evaluation
- Access route and valve type
- Intraoperative findings
- Postoperative outcomes
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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