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I35.1
ICD-10-CM
Aortic Valve Regurgitation

Understanding Aortic Valve Regurgitation (Aortic Insufficiency) is crucial for accurate clinical documentation and medical coding. This resource provides information on Aortic Regurgitation diagnosis, including symptoms, treatment options, and ICD-10 codes relevant for healthcare professionals. Learn about the causes and effects of Aortic Insufficiency and improve your medical coding accuracy.

Also known as

Aortic Insufficiency
Aortic Regurgitation

Diagnosis Snapshot

Key Facts
  • Definition : Backflow of blood from the aorta into the left ventricle.
  • Clinical Signs : Shortness of breath, chest pain, heart murmur, palpitations.
  • Common Settings : Outpatient cardiology clinic, hospital inpatient, cardiac ICU.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC I35.1 Coding
I34.0-I34.9

Nonrheumatic aortic valve disorders

Covers various nonrheumatic aortic valve conditions, including regurgitation.

I05-I09

Chronic rheumatic heart diseases

Includes rheumatic aortic valve diseases if applicable.

I35.0-I35.9

Nonrheumatic mitral valve disorders

Relevant if mitral valve involvement exists alongside aortic regurgitation.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the aortic regurgitation acute?

  • Yes

    Due to infective endocarditis?

  • No

    Is there rheumatic involvement?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Leaking aortic valve causes backflow into left ventricle.
Narrowing of aortic valve obstructs blood flow from left ventricle.
Combined stenosis and regurgitation of the aortic valve.

Documentation Best Practices

Documentation Checklist
  • Document regurgitation severity (mild, moderate, severe)
  • Specify cause of aortic regurgitation (e.g., bicuspid valve, endocarditis)
  • Describe any associated symptoms (e.g., dyspnea, chest pain)
  • Note relevant diagnostic findings (e.g., echocardiogram results)
  • Record NYHA functional class if applicable

Coding and Audit Risks

Common Risks
  • Unspecified Etiology

    Coding aortic regurgitation without specifying rheumatic, congenital, or other cause can lead to inaccurate severity and reimbursement.

  • Severity Miscoding

    Failing to document the severity (mild, moderate, severe) of aortic regurgitation impacts clinical data and payment.

  • Acute vs. Chronic

    Incorrectly coding acute aortic regurgitation as chronic, or vice versa, affects treatment and outcome tracking.

Mitigation Tips

Best Practices
  • ICD-10 I35.0, I35.1, I35.8, I35.9: Precise coding for severity, cause.
  • Document regurgitation jet severity, LV function for accurate RAF scores.
  • Echocardiography crucial for diagnosis, monitor progression, guide treatment.
  • Timely follow-up, lifestyle changes, medications per AHA/ACC guidelines.
  • Surgical intervention: document indications, type, complications for compliance.

Clinical Decision Support

Checklist
  • Confirm diastolic murmur auscultated. Document location, timing, character.
  • Review echocardiogram for aortic valve backflow. Quantify severity (mild, moderate, severe).
  • Assess patient symptoms dyspnea, chest pain, fatigue. Correlate with echo findings.
  • Check left ventricular size and function via echo or other imaging. Document LVEF.
  • Consider etiology bicuspid valve, rheumatic fever, endocarditis. Document cause.

Reimbursement and Quality Metrics

Impact Summary
  • Aortic Valve Regurgitation (Aortic Insufficiency) reimbursement hinges on accurate ICD-10 coding (I35.X) and supporting documentation for optimal payor outcomes.
  • Coding quality impacts AVR case mix index (CMI) accuracy, impacting hospital reimbursement and resource allocation.
  • Timely and specific coding for aortic regurgitation severity and etiology improves claim processing and reduces denials.
  • Accurate AVR reporting influences quality metrics like readmission rates and mortality, impacting public reporting and hospital value-based payments.

Streamline Your Medical Coding

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Frequently Asked Questions

Common Questions and Answers

Q: What are the key differentiating features in the physical exam findings of severe acute aortic regurgitation versus chronic severe aortic regurgitation?

A: Differentiating acute severe aortic regurgitation (AR) from chronic severe AR during physical examination relies on subtle yet crucial distinctions. In acute severe AR, the left ventricle has not had time to adapt to the volume overload. Consequently, you may observe normal or even decreased apical impulse amplitude due to limited ventricular filling time. Peripheral signs, such as a wide pulse pressure, are less prominent than in chronic AR. Auscultation may reveal a soft or absent early diastolic murmur because the pressure gradient develops rapidly. Conversely, chronic severe AR demonstrates a bounding apical impulse displaced laterally and inferiorly due to left ventricular hypertrophy. A prominent widened pulse pressure with a rapid upstroke and quick collapse (water-hammer pulse) is characteristic. A loud, high-pitched, early diastolic decrescendo murmur is typically heard at the left sternal border. Consider implementing a focused cardiac ultrasound to assess the severity of AR and left ventricular function. Explore how dynamic maneuvers during auscultation, such as handgrip, can further aid in the differential diagnosis.

Q: How do I interpret the echocardiographic findings for aortic regurgitation, specifically regarding quantifying severity and assessing left ventricular function?

A: Echocardiography is essential for evaluating aortic regurgitation (AR) severity and left ventricular (LV) function. Quantitative parameters include vena contracta width, regurgitant jet width relative to the left ventricular outflow tract, and regurgitant volume. A vena contracta width of >= 0.6cm, a regurgitant jet width/LVOT width ratio >= 65%, and a regurgitant volume >= 60ml all suggest severe AR. LV function assessment includes measuring ejection fraction (EF), fractional shortening, and LV end-diastolic and end-systolic dimensions. Reduced EF (<50%), increased LV dimensions, and impaired fractional shortening indicate LV dysfunction. Diastolic function assessment is crucial, including mitral inflow patterns, tissue Doppler imaging, and pulmonary vein flow. Explore how serial echocardiography can monitor disease progression and guide timely intervention. Learn more about the role of 3D echocardiography in complex cases.

Quick Tips

Practical Coding Tips
  • Code I06.1 for Aortic Regurgitation
  • Document jet size & severity
  • Specify acute vs. chronic
  • Check echo report for details
  • Consider I35.1 for rheumatic AR

Documentation Templates

Patient presents with symptoms suggestive of aortic valve regurgitation (AR), also known as aortic insufficiency.  Presenting complaints include shortness of breath, particularly with exertion (dyspnea on exertion), fatigue, and palpitations.  Physical examination revealed a diastolic murmur heard best at the left sternal border, a widened pulse pressure, and evidence of left ventricular hypertrophy on electrocardiogram (ECG).  The patient's medical history includes hypertension and hyperlipidemia, both potential contributing factors to aortic valve disease.  Transthoracic echocardiography (TTE) was ordered to assess aortic valve morphology and function, quantify the severity of regurgitation, and evaluate left ventricular size and function.  Differential diagnoses include mitral valve stenosis, other causes of valvular heart disease, and non-valvular causes of heart failure.  Preliminary assessment suggests chronic aortic regurgitation, likely secondary to degenerative valve disease.  Treatment options, including medical management for symptom control and the possibility of aortic valve replacement surgery, will be discussed with the patient following complete diagnostic workup.  ICD-10 code I06.1 (Aortic regurgitation) is anticipated.  Further evaluation and management will be documented upon completion of diagnostic testing and subsequent patient consultation.