ICD-10 Coding for Mechanical Heart Valve(T82.0XX, Z95.2)
Complete ICD-10-CM coding and documentation guide for Mechanical Heart Valve. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Mechanical Heart Valve
T82.0Primary Range
Mechanical complications of heart valve prosthesis
This range covers complications specific to mechanical heart valve prostheses, such as leakage, thrombosis, and dehiscence.
Presence of prosthetic heart valve
This code is used to indicate the presence of a prosthetic heart valve in the patient's medical history.
Non-rheumatic valve disorders
These codes are used for non-rheumatic valve disorders, which can coexist with mechanical valve issues.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| T82.0XX | Mechanical complication of heart valve prosthesis | Use when there is a documented mechanical complication of a heart valve prosthesis. |
|
| Z95.2 | Presence of prosthetic heart valve | Use to document the presence of a prosthetic valve without current complications. |
|
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 mechanical heart valve
Essential facts and insights about Mechanical Heart Valve
Primary ICD-10-CM Codes for mechanical heart valve
Decision Criteria
clinical Criteria
- Imaging confirms mechanical failure
documentation Criteria
- Explicit mention of mechanical complication
Applicable To
- Thrombosis
- Stenosis
- Leakage
- Dehiscence
Excludes
- Infective endocarditis (I33.0)
Clinical Validation Requirements
- Imaging evidence of mechanical failure
- Elevated INR with thrombus on TEE
Code-Specific Risks
- Misclassification if not confirmed by imaging
Coding Notes
- Ensure documentation specifies the type and nature of the complication.
Z95.2 - Presence of prosthetic heart valve
Use to document the presence of a prosthetic valve without current complications.
Applicable To
- History of heart valve replacement
Excludes
- Current complications of prosthetic valve (T82.0)
Clinical Validation Requirements
- Patient history confirming valve replacement
Coding Notes
Always used as a secondary code unless documenting history.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Presence of prosthetic heart valve
Z95.2Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Non-rheumatic mitral valve prolapse
I34.1Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Mechanical Heart Valve to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code T82.0XX.
Impact
Clinical: Impacts treatment decisions., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims.
Mitigation Strategy
Use templates for documentation, Regular training on documentation standards
Impact
Reimbursement: Incorrect DRG assignment may reduce payment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Ensure documentation specifies non-rheumatic etiology.
Impact
Using rheumatic codes for non-rheumatic valve issues.
Mitigation Strategy
Verify etiology in documentation.
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 Mechanical Heart Valve, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Mechanical Heart Valve
Use these documentation templates to ensure complete and accurate documentation for Mechanical Heart Valve. These templates include all required elements for proper coding and billing.
Mechanical valve complication
Specialty: CardiologyRequired Elements
- Valve type and model
- Complication description
- Imaging findings
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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