ICD-10 Coding for Severe Tricuspid Regurgitation(I07.1, I36.1)
Complete ICD-10-CM coding and documentation guide for Severe Tricuspid Regurgitation. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Severe 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 |
|---|---|---|---|
| I07.1 | Rheumatic tricuspid regurgitation | Use when rheumatic etiology is confirmed. |
|
| I36.1 | Nonrheumatic tricuspid regurgitation | Use for nonrheumatic causes such as annular dilation or lead-induced 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 severe tricuspid regurgitation
Essential facts and insights about Severe Tricuspid Regurgitation
Primary ICD-10-CM Codes for severe tricuspid regurgitation
Decision Criteria
clinical Criteria
- Presence of rheumatic fever history
Applicable To
- Rheumatic tricuspid valve insufficiency
Excludes
- Nonrheumatic tricuspid regurgitation (I36.1)
Clinical Validation Requirements
- History of rheumatic fever
- Echocardiographic evidence of commissural fusion
Code-Specific Risks
- Incorrectly coding nonrheumatic TR as rheumatic.
Coding Notes
- Ensure rheumatic etiology is documented.
I36.1 - Nonrheumatic tricuspid regurgitation
Use for nonrheumatic causes such as annular dilation or lead-induced regurgitation.
Applicable To
- Functional tricuspid regurgitation
Excludes
- Rheumatic tricuspid regurgitation (I07.1)
Clinical Validation Requirements
- Echocardiographic evidence of annular dilation
- Absence of rheumatic criteria
Coding Notes
Document specific nonrheumatic cause.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other mechanical complication of cardiac electronic device
T82.198ADocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Severe Tricuspid Regurgitation to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I07.1.
Impact
Clinical: Inadequate clinical picture for treatment planning., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Include detailed echo reports in patient records.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Ensure documentation specifies etiology clearly.
Impact
Inadequate documentation of TR etiology.
Mitigation Strategy
Ensure thorough 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 Severe Tricuspid Regurgitation, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Severe Tricuspid Regurgitation
Use these documentation templates to ensure complete and accurate documentation for Severe Tricuspid Regurgitation. These templates include all required elements for proper coding and billing.
Post-TEER procedure documentation
Specialty: CardiologyRequired Elements
- Procedure details
- Echocardiographic findings
- Patient symptoms
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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