Find comprehensive information on severe mitral regurgitation, including clinical documentation requirements, ICD-10 codes (I34.0, I34.1, I35.2), medical coding guidelines, and echocardiography findings. Learn about the symptoms, causes, and treatment options for severe MR, and understand the role of healthcare professionals in diagnosis and management. Explore resources for accurate medical record keeping and compliant coding practices related to this cardiac condition.
Also known as
Rheumatic heart diseases
Covers rheumatic mitral valve disorders, including regurgitation.
Other forms of heart disease
Includes non-rheumatic mitral regurgitation due to various causes.
Congenital malformations of heart
May be relevant if regurgitation is due to a congenital heart defect.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the mitral regurgitation acute?
Yes
Due to endocarditis?
No
Rheumatic?
When to use each related code
| Description |
|---|
| Severe mitral regurgitation |
| Moderate mitral regurgitation |
| Mitral valve prolapse |
Coding MR without specifying cause (rheumatic, degenerative, etc.) leads to inaccurate severity and DRG assignment. Impacts quality reporting and reimbursement.
Documentation lacking specific details (e.g., jet size, LV function) can cause downcoding from severe MR, impacting reimbursement and quality metrics.
Failing to distinguish acute from chronic MR can lead to incorrect coding and inaccurate reflection of patient acuity and resource utilization.
Q: What are the most effective evidence-based management strategies for severe mitral regurgitation in asymptomatic patients with preserved ejection fraction?
A: Managing asymptomatic severe mitral regurgitation (MR) with preserved ejection fraction (EF) requires a nuanced approach grounded in current guidelines and patient-specific factors. While traditionally watchful waiting was the norm, recent studies like the COAPT trial highlight the benefits of early intervention in select asymptomatic patients. Key management strategies include: 1. Regular monitoring: Echocardiography with comprehensive assessment of LV and LA size and function every 6-12 months is crucial to track disease progression. 2. Lifestyle modifications: Managing comorbidities like hypertension and atrial fibrillation is essential. 3. Pharmacological therapy: While no specific medication targets MR directly, managing heart failure symptoms and associated conditions with appropriate medications (e.g., ACE inhibitors, beta-blockers) is important. 4. Consideration of mitral valve intervention: For asymptomatic patients meeting specific criteria (e.g., progressive left ventricular enlargement, new-onset atrial fibrillation, pulmonary hypertension), early mitral valve repair or transcatheter edge-to-edge repair (TEER) may be beneficial. Decision-making requires careful evaluation of individual patient characteristics and shared decision-making with the patient. Explore how the latest guidelines from organizations like the American College of Cardiology and American Heart Association inform individualized management strategies for this patient population. Consider implementing a structured follow-up protocol for asymptomatic patients with severe MR to ensure timely intervention when indicated.
Q: How can I differentiate between primary (degenerative) and secondary (functional) mitral regurgitation using echocardiography, and what are the key implications for treatment decisions?
A: Distinguishing between primary and secondary mitral regurgitation (MR) is critical as it significantly influences treatment strategies. Echocardiography plays a central role in this differentiation. Key echocardiographic features suggestive of primary MR include: 1. Myxomatous degeneration or prolapse of mitral valve leaflets. 2. Thickened leaflets. 3. Chordal rupture or elongation. In contrast, secondary MR is characterized by: 1. Normal leaflet motion. 2. Dilated left ventricle. 3. Altered leaflet tethering geometry due to left ventricular remodeling, often seen in ischemic cardiomyopathy or dilated cardiomyopathy. Treatment implications differ considerably. Primary MR is often best managed with surgical or transcatheter mitral valve repair/replacement, while secondary MR treatment primarily focuses on optimizing medical therapy for the underlying cardiac condition, such as heart failure management. Mitral valve intervention for secondary MR is generally reserved for patients who remain symptomatic despite optimal medical therapy. Learn more about the specific echocardiographic parameters used to assess leaflet morphology, ventricular size and function, and the impact of these findings on treatment decisions in both primary and secondary MR.
Patient presents with symptoms suggestive of severe mitral regurgitation. Presenting complaints include progressively worsening dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea, and fatigue. Physical examination reveals a holosystolic murmur heard best at the apex, radiating to the axilla, with a palpable thrill. Jugular venous distension and peripheral edema are also noted. The patient reports a history of rheumatic heart disease, a known risk factor for mitral valve dysfunction. Echocardiography confirms severe mitral regurgitation, demonstrating a large regurgitant jet, left atrial enlargement, and left ventricular dilation. Left ventricular ejection fraction is currently preserved at 60%. The patient is diagnosed with severe mitral regurgitation (primary, secondary, or unspecified as determined by further evaluation). Differential diagnoses considered include aortic stenosis, mitral stenosis, and other causes of heart failure. Treatment plan includes optimal medical therapy with diuretics and vasodilators to manage heart failure symptoms. Surgical intervention, including mitral valve repair or replacement, is being considered and will be discussed with the patient. Referral to a cardiothoracic surgeon is scheduled. The patient's condition is being closely monitored for progression of symptoms and decline in cardiac function. ICD-10 code I05.1 (mitral regurgitation) is applied. Medical billing codes for evaluation and management, echocardiography, and other relevant services will be documented accordingly. Future assessments will focus on symptom management, optimization of medical therapy, and evaluation for surgical intervention.