ICD-10 Coding for Aortic Valve Regurgitation(I35.1, Q23.83)
Complete ICD-10-CM coding and documentation guide for Aortic Valve Regurgitation. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Aortic Valve Regurgitation
I35-I38Primary Range
Nonrheumatic aortic valve disorders
This range includes codes for nonrheumatic aortic valve disorders, including aortic valve regurgitation.
Congenital malformations of aortic and mitral valves
This range includes codes for congenital conditions such as bicuspid aortic valve, which may be associated with aortic regurgitation.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I35.1 | Nonrheumatic aortic (valve) insufficiency | Use when aortic regurgitation is confirmed to be nonrheumatic. |
|
| Q23.83 | Congenital bicuspid aortic valve | Use when aortic regurgitation is due to a congenital bicuspid aortic valve. |
|
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 aortic valve regurgitation
Essential facts and insights about Aortic Valve Regurgitation
Primary ICD-10-CM Codes for aortic valve regurgitation
Decision Criteria
clinical Criteria
- Nonrheumatic etiology confirmed by echocardiogram or clinical history
documentation Criteria
- Explicit mention of nonrheumatic causes such as degenerative calcification
Applicable To
- Nonrheumatic aortic regurgitation
Excludes
- Rheumatic aortic insufficiency (I06.1)
Clinical Validation Requirements
- Echocardiogram showing ≥45 mL/beat regurgitant volume, ≥50% regurgitant fraction, or ERO ≥0.30 cm²
- Documentation of nonrheumatic etiology such as degenerative calcification or bicuspid valve
Code-Specific Risks
- Incorrectly coding as rheumatic when etiology is not specified
Coding Notes
- Ensure documentation specifies nonrheumatic etiology to avoid defaulting to rheumatic coding.
Q23.83 - Congenital bicuspid aortic valve
Use when aortic regurgitation is due to a congenital bicuspid aortic valve.
Applicable To
- Bicuspid aortic valve
Clinical Validation Requirements
- Echocardiogram or surgical report confirming bicuspid valve morphology
Coding Notes
Ensure congenital nature of the valve is documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Congenital bicuspid aortic valve
Q23.83Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Rheumatic aortic insufficiency
I06.1Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Aortic Valve Regurgitation to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I35.1.
Impact
Clinical: Inadequate treatment planning., Regulatory: Non-compliance with documentation standards., Financial: Potential loss of reimbursement due to incorrect DRG.
Mitigation Strategy
Use echocardiogram findings to document severity, Ensure all clinical notes include severity metrics
Impact
Reimbursement: Incorrect DRG assignment may affect reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Ensure documentation specifies nonrheumatic etiology or query provider.
Impact
Lack of specific etiology documentation leading to incorrect coding.
Mitigation Strategy
Implement mandatory etiology documentation in cardiology assessments.
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 Aortic Valve Regurgitation, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Aortic Valve Regurgitation
Use these documentation templates to ensure complete and accurate documentation for Aortic Valve Regurgitation. These templates include all required elements for proper coding and billing.
Nonrheumatic Aortic Regurgitation
Specialty: CardiologyRequired Elements
- Etiology
- Severity metrics
- Echocardiogram findings
- Symptoms
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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