ICD-10 Coding for Mitral Valve Stenosis(I34.2, I05.0, Q23.2)
Complete ICD-10-CM coding and documentation guide for Mitral Valve Stenosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Mitral Valve Stenosis
I34-I38Primary Range
Nonrheumatic mitral valve disorders
Includes nonrheumatic mitral valve stenosis, the primary condition discussed.
Rheumatic heart diseases
Includes rheumatic mitral valve stenosis, relevant for differential diagnosis.
Congenital malformations of the circulatory system
Includes congenital mitral valve stenosis, relevant for differential diagnosis.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I34.2 | Nonrheumatic mitral (valve) stenosis | Use when mitral stenosis is confirmed as nonrheumatic through clinical documentation. |
|
| I05.0 | Rheumatic mitral stenosis | Use when mitral stenosis is confirmed as rheumatic through clinical documentation. |
|
| Q23.2 | Congenital mitral stenosis | Use when mitral stenosis is confirmed as congenital through clinical documentation. |
|
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 nonrheumatic mitral valve stenosis
Essential facts and insights about Mitral Valve Stenosis
Primary ICD-10-CM Codes for mitral valve stenosis
Decision Criteria
clinical Criteria
- Echocardiogram findings with valve area ≤2.5 cm²
documentation Criteria
- No history of rheumatic fever
Applicable To
- Degenerative mitral stenosis
- Calcific mitral stenosis
Clinical Validation Requirements
- Echocardiogram showing valve area ≤2.5 cm²
- No history of rheumatic fever
Code-Specific Risks
- Incorrectly coding rheumatic stenosis as nonrheumatic
Coding Notes
- Ensure documentation explicitly states 'nonrheumatic' to avoid miscoding.
I05.0 - Rheumatic mitral stenosis
Use when mitral stenosis is confirmed as rheumatic through clinical documentation.
Applicable To
- Rheumatic mitral valve stenosis
Excludes
- Nonrheumatic mitral stenosis (I34.2)
Clinical Validation Requirements
- History of rheumatic fever
- Echocardiogram showing commissural fusion
Coding Notes
Ensure documentation specifies 'rheumatic' to avoid miscoding.
Q23.2 - Congenital mitral stenosis
Use when mitral stenosis is confirmed as congenital through clinical documentation.
Applicable To
- Parachute mitral valve
- Hypoplastic mitral valve
Excludes
- Nonrheumatic mitral stenosis (I34.2)
- Rheumatic mitral stenosis (I05.0)
Clinical Validation Requirements
- Documented congenital anomaly
- Echocardiogram confirmation
Coding Notes
Ensure documentation specifies congenital nature to avoid miscoding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Acute systolic heart failure
I50.21Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Mitral Valve Stenosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I34.2.
Impact
Clinical: May lead to inappropriate treatment decisions., Regulatory: Non-compliance with coding guidelines., Financial: Potential loss of reimbursement due to incorrect DRG assignment.
Mitigation Strategy
Thorough review of patient history, Detailed echocardiogram documentation
Impact
Reimbursement: Incorrect coding can lead to improper DRG assignment., Compliance: May result in compliance issues with coding standards., Data Quality: Affects the accuracy of clinical data and reporting.
Mitigation Strategy
Ensure documentation specifies the etiology of stenosis.
Impact
Failure to specify etiology can lead to audit findings.
Mitigation Strategy
Ensure comprehensive documentation of patient history and diagnostic findings.
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 Stenosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Mitral Valve Stenosis
Use these documentation templates to ensure complete and accurate documentation for Mitral Valve Stenosis. These templates include all required elements for proper coding and billing.
Nonrheumatic mitral stenosis with heart failure
Specialty: CardiologyRequired Elements
- Patient history
- Echocardiogram results
- Symptom description
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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