Find comprehensive information on mitral insufficiency, including clinical documentation requirements, medical coding guidelines (ICD-10-CM I34.0, I34.1, I34.2, I34.8, I34.9), and healthcare best practices for diagnosis and treatment. Learn about mitral regurgitation symptoms, severity assessment, echocardiogram interpretation, and treatment options. This resource provides valuable insights for physicians, coders, and other healthcare professionals seeking accurate and up-to-date information on mitral valve disease management.
Also known as
Rheumatic heart diseases
Mitral insufficiency can be caused by rheumatic fever.
Other forms of heart disease
Includes non-rheumatic mitral valve disorders like prolapse and regurgitation.
Congenital malformations of heart
Some congenital heart defects can lead to mitral insufficiency.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the mitral insufficiency acute?
Yes
Due to rheumatic fever?
No
Is it chronic?
When to use each related code
| Description |
|---|
| Mitral valve leaks during heart contraction. |
| Aortic valve leaks after heart contraction. |
| Mitral valve narrowed, obstructing blood flow. |
Coding mitral insufficiency without specifying severity (mild, moderate, severe) leads to inaccurate DRG assignment and reimbursement.
Missing or unclear documentation of the underlying cause of mitral insufficiency (e.g., rheumatic, degenerative) impacts coding accuracy and quality metrics.
Failure to distinguish between acute and chronic mitral insufficiency can lead to incorrect code selection and affect patient care management.
Patient presents with symptoms suggestive of mitral insufficiency, including dyspnea, fatigue, and orthopnea. Physical examination revealed a holosystolic murmur at the apex, radiating to the axilla. The patient reports a history of rheumatic heart disease, a known risk factor for mitral valve regurgitation. Echocardiography confirms the diagnosis of moderate mitral insufficiency, demonstrating mitral valve prolapse with posterior leaflet flail and eccentric mitral regurgitant jet. Left atrial enlargement and left ventricular dilation are also noted. The patient's ejection fraction is currently preserved. Assessment includes mitral regurgitation, secondary to rheumatic heart disease, with New York Heart Association Class II functional capacity. Differential diagnosis considered mitral valve prolapse syndrome, ischemic mitral regurgitation, and infective endocarditis. Plan includes medical management with diuretics and vasodilators to address heart failure symptoms. Close monitoring of left ventricular function and mitral regurgitation severity will be undertaken. Surgical mitral valve repair or replacement will be considered if medical therapy fails to control symptoms or if left ventricular dysfunction progresses. Patient education provided regarding the importance of medication adherence, regular follow-up appointments, and lifestyle modifications including sodium restriction and appropriate exercise. ICD-10 code I05.1, mitral regurgitation, specified as rheumatic, has been documented.