ICD-10 Coding for Mitral and Tricuspid Regurgitation(I08.3, I34.0, I07.1)
Complete ICD-10-CM coding and documentation guide for Mitral and Tricuspid Regurgitation. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Mitral and Tricuspid 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 |
|---|---|---|---|
| I08.3 | Combined rheumatic mitral, aortic, and tricuspid valve disorders | Use when all three valves are affected by rheumatic disease. |
|
| I34.0 | Non-rheumatic mitral valve prolapse | Use for non-rheumatic mitral valve prolapse. |
|
| I07.1 | Rheumatic tricuspid insufficiency | Use for rheumatic tricuspid 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 mitral and tricuspid regurgitation
Essential facts and insights about Mitral and Tricuspid Regurgitation
Primary ICD-10-CM Codes for mitral tricuspid regurgitation
Decision Criteria
clinical Criteria
- Confirmed rheumatic fever history and echocardiographic evidence
Applicable To
- Rheumatic mitral and tricuspid regurgitation
Excludes
- Non-rheumatic valve disorders
Clinical Validation Requirements
- History of rheumatic fever
- Echocardiogram showing rheumatic changes in valves
Code-Specific Risks
- Incorrectly coding non-rheumatic conditions as rheumatic
Coding Notes
- Ensure rheumatic etiology is documented clearly.
I34.0 - Non-rheumatic mitral valve prolapse
Use for non-rheumatic mitral valve prolapse.
Applicable To
- Mitral valve prolapse
Excludes
- Rheumatic mitral valve disorders
Clinical Validation Requirements
- Echocardiogram showing prolapse without rheumatic changes
Coding Notes
Document the absence of rheumatic history.
I07.1 - Rheumatic tricuspid insufficiency
Use for rheumatic tricuspid regurgitation.
Applicable To
- Rheumatic tricuspid regurgitation
Excludes
- Non-rheumatic tricuspid valve disorders
Clinical Validation Requirements
- History of rheumatic fever
- Echocardiogram showing rheumatic changes in tricuspid valve
Coding Notes
Ensure rheumatic etiology is documented clearly.
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.
Non-rheumatic mitral valve prolapse
I34.0Combined rheumatic mitral, aortic, and tricuspid valve disorders
I08.3Non-rheumatic tricuspid valve insufficiency
I36.1Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Mitral and Tricuspid Regurgitation to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I08.3.
Impact
Clinical: Inaccurate treatment planning, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Ensure complete documentation in clinical notes, Review echocardiogram reports for etiology
Impact
Reimbursement: Incorrect coding can lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Verify rheumatic history and echocardiographic evidence before coding.
Impact
Inaccurate coding due to unclear documentation of etiology.
Mitigation Strategy
Implement thorough documentation practices and regular audits.
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 Mitral and Tricuspid Regurgitation, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Mitral and Tricuspid Regurgitation
Use these documentation templates to ensure complete and accurate documentation for Mitral and Tricuspid Regurgitation. These templates include all required elements for proper coding and billing.
Post-Echocardiogram Documentation
Specialty: CardiologyRequired Elements
- Valve affected
- Severity
- Etiology
- Echocardiographic findings
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Mitral and Tricuspid Regurgitation? Ask your questions below.