ICD-10 Coding for Valve Disorder(I05.0, I34.0)
Complete ICD-10-CM coding and documentation guide for Valve Disorder. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Valve Disorder
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I05.0 | Rheumatic mitral stenosis | Use when mitral stenosis is confirmed to be rheumatic in origin. |
|
| I34.0 | Nonrheumatic mitral insufficiency | Use for mitral insufficiency without a history of rheumatic fever. |
|
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 rheumatic mitral stenosis
Essential facts and insights about Valve Disorder
Primary ICD-10-CM Codes for valve disorder
Decision Criteria
clinical Criteria
- History of rheumatic fever and echocardiogram findings.
Applicable To
- Mitral stenosis due to rheumatic fever
Excludes
- Nonrheumatic mitral stenosis
Clinical Validation Requirements
- History of rheumatic fever
- Echocardiogram showing commissural fusion
Code-Specific Risks
- Incorrectly coding nonrheumatic mitral stenosis as rheumatic.
Coding Notes
- Ensure documentation specifies rheumatic origin.
I34.0 - Nonrheumatic mitral insufficiency
Use for mitral insufficiency without a history of rheumatic fever.
Applicable To
- Degenerative mitral valve disease
Excludes
- Rheumatic mitral insufficiency
Clinical Validation Requirements
- Echocardiogram showing myxomatous degeneration or annular calcification
Coding Notes
Document etiology as nonrheumatic.
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 Valve Disorder to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I05.0.
Impact
Clinical: Misleading clinical data affecting treatment decisions., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims due to incorrect coding.
Mitigation Strategy
Use structured documentation templates., Educate clinicians on the importance of etiology documentation.
Impact
Reimbursement: Incorrect DRG assignment leading to reimbursement issues., Compliance: Potential audit failures due to incorrect coding., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Verify and document the etiology of the valve disorder.
Impact
Risk of coding nonrheumatic disorders as rheumatic.
Mitigation Strategy
Implement mandatory etiology documentation in EHR.
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 Valve Disorder, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Valve Disorder
Use these documentation templates to ensure complete and accurate documentation for Valve Disorder. These templates include all required elements for proper coding and billing.
Cardiology consultation for valve disorder
Specialty: CardiologyRequired Elements
- Etiology
- Valve(s) involved
- Severity
- Symptoms
- Imaging findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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