ICD-10 Coding for Mild Tricuspid Regurgitation(I36.1)
Complete ICD-10-CM coding and documentation guide for Mild Tricuspid Regurgitation. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Mild Tricuspid Regurgitation
I36-I37Primary Range
Diseases of the tricuspid and pulmonary valves
This range includes codes for tricuspid valve disorders, including nonrheumatic tricuspid regurgitation.
Key Information: ICD-10 code for mild tricuspid regurgitation
Essential facts and insights about Mild Tricuspid Regurgitation
Primary ICD-10-CM Code for mild tricuspid regurgitation
Decision Criteria
clinical Criteria
- Echocardiographic evidence of nonrheumatic tricuspid regurgitation
documentation Criteria
- Explicit mention of nonrheumatic etiology
Applicable To
- Functional tricuspid regurgitation
- Mild tricuspid valve regurgitation
Excludes
- Rheumatic tricuspid insufficiency (I07.1)
Clinical Validation Requirements
- Echocardiography showing VC width ≤3 mm
- Jet area <5 cm²
- No right atrial/ventricular enlargement
Code-Specific Risks
- Incorrectly coding rheumatic cases as nonrheumatic
- Omitting etiology in documentation
Coding Notes
- Ensure documentation specifies nonrheumatic etiology and includes echocardiographic findings.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Rheumatic tricuspid insufficiency
I07.1Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Mild Tricuspid Regurgitation to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I36.1.
Impact
Clinical: Inadequate clinical information for treatment planning., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials due to insufficient documentation.
Mitigation Strategy
Use standardized templates for documentation., Regular training on documentation requirements.
Impact
Reimbursement: Incorrect DRG assignment leading to potential underpayment., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Verify etiology through patient history and echocardiographic findings.
Impact
Failure to document etiology can lead to incorrect coding.
Mitigation Strategy
Implement mandatory fields in EHR for etiology 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 Mild Tricuspid Regurgitation, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Mild Tricuspid Regurgitation
Use these documentation templates to ensure complete and accurate documentation for Mild Tricuspid Regurgitation. These templates include all required elements for proper coding and billing.
Cardiology Consult for Mild TR
Specialty: CardiologyRequired Elements
- Etiology of TR
- Severity based on echocardiography
- Associated symptoms
- Related conditions
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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