ICD-10 Coding for Severe Mitral Regurgitation(I34.0)
Complete ICD-10-CM coding and documentation guide for Severe Mitral Regurgitation. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Severe Mitral Regurgitation
I34-I39Primary Range
Nonrheumatic mitral valve disorders
This range includes codes for nonrheumatic mitral valve disorders, including severe mitral regurgitation.
Key Information: ICD-10 code for severe mitral regurgitation
Essential facts and insights about Severe Mitral Regurgitation
Primary ICD-10-CM Code for severe mitral regurgitation
Decision Criteria
clinical Criteria
- Presence of severe regurgitation metrics on echocardiogram.
Applicable To
- Degenerative mitral valve disease
- Myxomatous degeneration
Excludes
- Rheumatic mitral insufficiency (I05.1)
Clinical Validation Requirements
- EROA ≥0.40 cm²
- Regurgitant volume ≥60 mL
- Vena contracta ≥0.7 cm
Code-Specific Risks
- Confusion with rheumatic codes if etiology is not specified.
Coding Notes
- Ensure documentation clearly states nonrheumatic etiology to avoid incorrect coding.
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 Severe Mitral Regurgitation to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I34.0.
Impact
Clinical: Misrepresentation of patient condition., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Ensure detailed documentation of valve pathology.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Verify etiology in documentation; use I34.0 for nonrheumatic cases.
Impact
Risk of incorrect coding due to unspecified etiology.
Mitigation Strategy
Implement mandatory etiology documentation in EHR templates.
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 Mitral Regurgitation, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Severe Mitral Regurgitation
Use these documentation templates to ensure complete and accurate documentation for Severe Mitral Regurgitation. These templates include all required elements for proper coding and billing.
Chronic Severe Mitral Regurgitation
Specialty: CardiologyRequired Elements
- Etiology and severity
- Quantitative echocardiographic findings
- Symptoms and functional status
- Intervention indications
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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