ICD-10 Coding for Valvular Heart Disease(I05.0, I34.0, Q23.83)
Complete ICD-10-CM coding and documentation guide for Valvular Heart Disease. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Valvular 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 |
|---|---|---|---|
| I05.0 | Rheumatic mitral stenosis | Use when mitral stenosis is confirmed as rheumatic in origin. |
|
| I34.0 | Nonrheumatic mitral valve stenosis | Use when mitral stenosis is nonrheumatic. |
|
| Q23.83 | Congenital bicuspid aortic valve | Use for congenital bicuspid aortic valve cases. |
|
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 nonrheumatic mitral stenosis
Essential facts and insights about Valvular Heart Disease
Primary ICD-10-CM Codes for valvular heart disease
Decision Criteria
clinical Criteria
- Rheumatic history and echocardiogram findings
Applicable To
- Rheumatic mitral valve stenosis
Excludes
- Nonrheumatic mitral stenosis
Clinical Validation Requirements
- Echocardiogram showing mitral valve area ≤1.5 cm²
- Evidence of rheumatic changes
Code-Specific Risks
- Misclassification if rheumatic origin is not confirmed
Coding Notes
- Ensure rheumatic origin is documented.
I34.0 - Nonrheumatic mitral valve stenosis
Use when mitral stenosis is nonrheumatic.
Applicable To
- Degenerative mitral stenosis
Excludes
- Rheumatic mitral stenosis
Clinical Validation Requirements
- Echocardiogram showing mitral valve area ≤1.5 cm²
- No evidence of rheumatic changes
Coding Notes
Document nonrheumatic etiology clearly.
Q23.83 - Congenital bicuspid aortic valve
Use for congenital bicuspid aortic valve cases.
Applicable To
- Bicuspid aortic valve
Clinical Validation Requirements
- Echocardiogram or CT confirming bicuspid aortic valve
Coding Notes
Document congenital nature and associated conditions.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Valvular Heart Disease 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, Regulatory: Potential audit issues, Financial: Incorrect billing and reimbursement
Mitigation Strategy
Always document etiology, Use specific codes
Impact
Reimbursement: Incorrect DRG assignment, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate clinical data
Mitigation Strategy
Code each valve separately using I34.x and I35.x
Impact
Use of unspecified codes can trigger audits.
Mitigation Strategy
Ensure detailed documentation of etiology and severity.
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 Valvular Heart Disease, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Valvular Heart Disease
Use these documentation templates to ensure complete and accurate documentation for Valvular Heart Disease. These templates include all required elements for proper coding and billing.
Nonrheumatic mitral valve insufficiency
Specialty: CardiologyRequired Elements
- Etiology
- Severity
- Echocardiogram findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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