ICD-10 Coding for Mitral Valve Endocarditis(I33.0, B95.61)
Complete ICD-10-CM coding and documentation guide for Mitral Valve Endocarditis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Mitral Valve Endocarditis
I33-I39Primary Range
Diseases of mitral valve
This range includes codes for various forms of endocarditis and valve disorders, with I33.0 being specific to acute and subacute infective endocarditis.
Bacterial and viral infectious agents
These codes are used to identify the specific organism causing the endocarditis, such as Staphylococcus or Streptococcus.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I33.0 | Acute and subacute infective endocarditis | Use when acute or subacute infective endocarditis of the mitral valve is confirmed with clinical evidence. |
|
| B95.61 | Staphylococcus aureus as the cause of diseases classified elsewhere | Use as an additional code when Staphylococcus aureus is identified as the causative organism. |
|
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 valve endocarditis
Essential facts and insights about Mitral Valve Endocarditis
Primary ICD-10-CM Codes for mitral valve endocarditis
Decision Criteria
clinical Criteria
- Presence of vegetation on echocardiogram and positive blood cultures
Applicable To
- Infective endocarditis of the mitral valve
Excludes
- Rheumatic mitral valve disease (I01.1)
Clinical Validation Requirements
- Positive blood cultures for typical organisms
- Echocardiogram showing vegetation
Code-Specific Risks
- Misclassification as unspecified endocarditis if acuity is not documented
Coding Notes
- Ensure documentation specifies acute or subacute and identifies the causative organism.
B95.61 - Staphylococcus aureus as the cause of diseases classified elsewhere
Use as an additional code when Staphylococcus aureus is identified as the causative organism.
Applicable To
- Infections due to Staphylococcus aureus
Clinical Validation Requirements
- Blood cultures positive for Staphylococcus aureus
Coding Notes
Ensure organism is specified in the clinical documentation.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Heart failure, unspecified
I50.9Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Mitral Valve Endocarditis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I33.0.
Impact
Clinical: Inadequate treatment planning due to unspecified organism., Regulatory: Potential audit issues for incomplete documentation., Financial: Missed opportunities for accurate DRG assignment.
Mitigation Strategy
Ensure blood culture results are documented and coded.
Impact
Reimbursement: Incorrect DRG assignment may affect payment., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use I33.0 when documentation specifies acute or subacute endocarditis.
Impact
Failure to code the causative organism can lead to audit discrepancies.
Mitigation Strategy
Implement a checklist to ensure organism documentation is complete.
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 Valve Endocarditis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Mitral Valve Endocarditis
Use these documentation templates to ensure complete and accurate documentation for Mitral Valve Endocarditis. These templates include all required elements for proper coding and billing.
Acute Mitral Valve Endocarditis
Specialty: CardiologyRequired Elements
- Patient history of fever and embolic events
- Echocardiogram findings
- Blood culture results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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