ICD-10 Coding for Transcatheter Aortic Valve Replacement (TAVR)(I35.0, Z00.6)
Complete ICD-10-CM coding and documentation guide for Transcatheter Aortic Valve Replacement (TAVR). Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Transcatheter Aortic Valve Replacement (TAVR)
I35-I37Primary Range
Nonrheumatic aortic valve disorders
This range includes codes for aortic stenosis, which is the primary condition treated by TAVR.
Factors influencing health status and contact with health services
Includes codes for clinical trial participation, relevant for TAVR procedures conducted under research protocols.
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 stenosis | Use when documenting aortic stenosis as the primary diagnosis for TAVR. |
|
| Z00.6 | Encounter for examination in clinical research program | Use as a secondary code when the procedure is part of a clinical trial. |
|
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 TAVR
Essential facts and insights about Transcatheter Aortic Valve Replacement (TAVR)
Primary ICD-10-CM Codes for tavr
Decision Criteria
clinical Criteria
- Patient exhibits severe symptomatic aortic stenosis with nonrheumatic origin.
Applicable To
- Severe symptomatic aortic stenosis
Excludes
- Rheumatic aortic stenosis (I06.0)
Clinical Validation Requirements
- Echocardiography showing AVA <1.0 cm²
- Mean gradient >40 mmHg
- Symptoms such as syncope or angina
Code-Specific Risks
- Incorrectly coding rheumatic stenosis as nonrheumatic
Coding Notes
- Ensure documentation specifies nonrheumatic origin to avoid misclassification.
Z00.6 - Encounter for examination in clinical research program
Use as a secondary code when the procedure is part of a clinical trial.
Applicable To
- Participation in clinical trials
Clinical Validation Requirements
- Documentation of clinical trial enrollment
Coding Notes
Ensure the clinical trial number is documented in the patient's record.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Encounter for examination in clinical research program
Z00.6Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Rheumatic aortic stenosis
I06.0Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Transcatheter Aortic Valve Replacement (TAVR) to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I35.0.
Impact
Clinical: May lead to inappropriate treatment decisions., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials or reduced reimbursement.
Mitigation Strategy
Ensure detailed imaging reports are included., Verify documentation of valve morphology in the pre-op assessment.
Impact
Reimbursement: Claims may be denied or underpaid., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate representation of surgical team involvement.
Mitigation Strategy
Always apply Modifier 62 when two surgeons are involved in the procedure.
Impact
Reimbursement: Potential denial of claims related to trial participation., Compliance: Failure to meet clinical trial reporting requirements., Data Quality: Incomplete data on clinical trial involvement.
Mitigation Strategy
Ensure Z00.6 is included when the procedure is part of a clinical trial.
Impact
Inadequate documentation of trial participation can lead to audits.
Mitigation Strategy
Ensure all trial-related documentation is complete and accurate.
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 Transcatheter Aortic Valve Replacement (TAVR), with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Transcatheter Aortic Valve Replacement (TAVR)
Use these documentation templates to ensure complete and accurate documentation for Transcatheter Aortic Valve Replacement (TAVR). These templates include all required elements for proper coding and billing.
TAVR Procedure Documentation
Specialty: CardiologyRequired Elements
- Indication for TAVR
- Heart team evaluation
- Imaging findings
- Clinical trial details
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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