Find information on nonrheumatic mitral valve regurgitation including clinical documentation requirements, ICD-10-CM codes I05.1, I05.8, I34.0, and I34.8, medical coding guidelines, and healthcare resources for diagnosis and treatment. Learn about mitral regurgitation severity, echocardiogram interpretation, and effective clinical care pathways. This resource offers guidance on proper documentation and coding for nonrheumatic mitral valve regurgitation for physicians, coders, and other healthcare professionals.
Also known as
Chronic rheumatic heart diseases
Includes chronic rheumatic mitral valve disorders, often causing regurgitation.
Mitral valve disorders
Encompasses various mitral valve problems, including nonrheumatic regurgitation.
Mitral regurgitation
Specifically identifies mitral regurgitation, both rheumatic and nonrheumatic.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the mitral regurgitation acute?
Yes
Is it due to infective endocarditis?
No
Is it caused by a cleft or anomaly?
When to use each related code
| Description |
|---|
| Mitral regurgitation, nonrheumatic |
| Mitral valve prolapse |
| Ischemic mitral regurgitation |
Coding I05.1 without specifying underlying cause (e.g., I05.8, I07.1) leads to inaccurate severity and reimbursement. Impacts CDI, coding audits, and quality metrics.
Inconsistent documentation of regurgitation severity (mild, moderate, severe) with echocardiogram findings. Risk for incorrect coding, denials, and compliance issues.
Overlapping conditions like mitral valve prolapse (I34.x) and mitral valve regurgitation. Accurate coding requires careful differentiation for appropriate reimbursement and clinical data.
Patient presents with symptoms suggestive of nonrheumatic mitral valve regurgitation (MR), including dyspnea, fatigue, and orthopnea. Physical examination revealed a holosystolic murmur at the apex, radiating to the axilla. The patient denies a history of rheumatic fever. Echocardiography confirms the diagnosis of moderate mitral regurgitation, with evidence of mitral valve prolapse and annular dilatation. Left ventricular ejection fraction (LVEF) is currently preserved at 60%. Differential diagnoses considered include ischemic mitral regurgitation and mitral valve stenosis, but these were ruled out based on echocardiographic findings and lack of angina symptoms. Assessment includes moderate nonrheumatic mitral regurgitation secondary to mitral valve prolapse, New York Heart Association (NYHA) functional class II. Plan includes initiating treatment with diuretics to manage fluid overload and symptoms. Patient education provided regarding lifestyle modifications, including sodium restriction and regular exercise. Follow-up echocardiography scheduled in six months to monitor disease progression and LVEF. Referral to cardiology for further evaluation and consideration for mitral valve repair or replacement surgery if symptoms worsen or LVEF declines. ICD-10 code I05.1, mitral regurgitation, is documented. Medical necessity for the prescribed medications and diagnostic tests is established.