Find information on mild aortic stenosis diagnosis, including ICD-10 codes (I35.0), clinical documentation improvement (CDI) best practices, aortic valve area calculation, and echocardiogram interpretation. Learn about symptoms, treatment options, and the impact of mild AS on left ventricular ejection fraction (LVEF). Understand the role of healthcare professionals in managing and documenting this cardiac condition, along with relevant medical coding guidelines for accurate reimbursement.
Also known as
Aortic valve stenosis
Mild narrowing of the aortic valve.
Rheumatic heart diseases
Heart conditions caused by rheumatic fever, sometimes leading to stenosis.
Congenital aortic stenosis
Aortic valve narrowing present from birth, which can be mild.
Aortic valve insufficiency
While not stenosis, often co-occurs impacting overall valve function.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the aortic stenosis congenital?
Yes
Is it nonrheumatic?
No
Is it calcified?
When to use each related code
| Description |
|---|
| Mild Aortic Stenosis |
| Moderate Aortic Stenosis |
| Aortic Sclerosis |
Coding aortic stenosis without specifying mild severity can lead to underpayment and inaccurate risk adjustment. Document and code mild status explicitly.
Confusing asymptomatic aortic stenosis with mild stenosis. Asymptomatic patients might not meet criteria for mild AS diagnosis. Clear documentation is crucial.
Lack of echocardiogram or other imaging results confirming mild aortic stenosis can cause claim denials. Ensure complete documentation linking diagnosis to objective findings.
Patient presents with mild aortic stenosis, confirmed by echocardiography demonstrating a mean aortic valve gradient between 10-25 mmHg and an aortic valve area (AVA) greater than 1.5 cm2. Symptoms, if present, may include mild dyspnea on exertion, fatigue, or chest pain. The patient denies syncope or angina. Physical examination reveals a normal apical impulse and a crescendo-decrescendo systolic murmur best heard at the right second intercostal space, radiating to the carotids. Electrocardiogram (ECG) shows normal sinus rhythm without significant ST-T wave changes. Left ventricular ejection fraction (LVEF) is preserved. Diagnosis of mild aortic stenosis is consistent with current ACCAHA guidelines. Plan includes conservative management with regular monitoring including repeat echocardiography in 12-24 months to assess disease progression. Patient education provided regarding symptoms to monitor and the importance of follow-up. Differential diagnosis included bicuspid aortic valve, rheumatic aortic stenosis, and other causes of valvular heart disease. Medical coding will utilize ICD-10 code I35.0 for aortic stenosis and relevant CPT codes for echocardiography and office visit. Treatment plan discussed and documented, focusing on watchful waiting and risk factor modification for cardiovascular disease including hypertension, hyperlipidemia, and diabetes.