ICD-10 Coding for Severe Aortic Valve Stenosis(I35.0, I06.0)
Complete ICD-10-CM coding and documentation guide for Severe Aortic Valve Stenosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Severe Aortic Valve Stenosis
I35-I38Primary Range
Nonrheumatic valve disorders
This range includes nonrheumatic aortic stenosis, which is the primary focus for severe aortic valve stenosis without rheumatic etiology.
Rheumatic valve disorders
This range is relevant when severe aortic valve stenosis is due to rheumatic heart disease.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I35.0 | Nonrheumatic aortic (valve) stenosis | Use when aortic stenosis is nonrheumatic and meets severe criteria. |
|
| I06.0 | Rheumatic aortic stenosis | Use when aortic stenosis is due to rheumatic heart disease. |
|
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 severe aortic valve stenosis
Essential facts and insights about Severe Aortic Valve Stenosis
Primary ICD-10-CM Codes for severe aortic valve stenosis
Decision Criteria
clinical Criteria
- Severe stenosis criteria met with echocardiogram findings.
documentation Criteria
- Nonrheumatic etiology explicitly documented.
Applicable To
- Calcific aortic stenosis
Excludes
- Rheumatic aortic stenosis (I06.0)
Clinical Validation Requirements
- AVA <1.0 cm²
- MPG >40 mmHg
- Vmax >4 m/s
Code-Specific Risks
- Incorrectly coding as rheumatic without documentation.
Coding Notes
- Ensure documentation specifies nonrheumatic etiology.
I06.0 - Rheumatic aortic stenosis
Use when aortic stenosis is due to rheumatic heart disease.
Applicable To
- Rheumatic aortic stenosis
Excludes
- Nonrheumatic aortic stenosis (I35.0)
Clinical Validation Requirements
- History of rheumatic fever
- Positive rheumatic markers
Coding Notes
Document rheumatic history clearly.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Presence of prosthetic heart valve
Z95.2Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Severe Aortic Valve Stenosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I35.0.
Impact
Clinical: Inadequate assessment of condition severity., Regulatory: Non-compliance with coding standards., Financial: Potential reimbursement issues.
Mitigation Strategy
Include echocardiogram results in documentation., Specify AVA and gradient measurements.
Impact
Reimbursement: Potential for incorrect DRG assignment., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate clinical data reporting.
Mitigation Strategy
Verify and document the etiology as nonrheumatic.
Impact
Risk of coding errors due to unclear etiology documentation.
Mitigation Strategy
Implement mandatory etiology documentation protocols.
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 Severe Aortic Valve Stenosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Severe Aortic Valve Stenosis
Use these documentation templates to ensure complete and accurate documentation for Severe Aortic Valve Stenosis. These templates include all required elements for proper coding and billing.
Severe Aortic Stenosis Evaluation
Specialty: CardiologyRequired Elements
- Etiology
- Severity metrics
- Symptom correlation
- Test results
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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