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v1.0.0
ICD-10 Guide
DiagnosesAortic Valve Disease

Aortic Valve Disease

ICD-10 Coding for Aortic Valve Disease(I35.0, I35.1, Q23.81)

PRIMARY SPECIALTYCardiology
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Aortic Valve Disease?
Essential facts and insights about Aortic Valve Disease

Key Clinical Considerations:

  • Patients may present with symptoms such as dyspnea, angina, syncope, or heart failure.
  • Echocardiography may reveal aortic stenosis, regurgitation, or other valvular abnormalities.
  • Physical examination may show a systolic ejection murmur, diastolic murmur, or signs of heart failure.
  • Imaging studies like echocardiograms, CT scans, or MRIs can provide detailed views of valve structure and function.
  • Severity can be assessed based on the degree of stenosis or regurgitation, often classified as mild, moderate, or severe.

Clinical Information

Clinical Criteria & Documentation Requirements

  • Document the patient's symptoms, duration, and impact on daily activities.
  • Use specific terminology such as 'aortic stenosis' or 'aortic regurgitation' as appropriate.
  • Examples include: 'Patient diagnosed with severe aortic stenosis based on echocardiographic findings.'
  • Document medical necessity for interventions such as valve replacement or repair.
  • Include quality measures such as monitoring for heart failure symptoms or follow-up echocardiograms.

Coding Guidelines

Usage Guidelines & Examples

  • Use I35.0 for aortic stenosis, I35.1 for aortic regurgitation, and Q23.81 for congenital aortic valve disease.
  • Do not use these codes for non-valvular heart diseases or other cardiac conditions.
  • I35.0 and I35.1 are specific to aortic valve disease, while I34 codes pertain to other heart valve diseases.
  • Common errors include misclassifying the type of valve disease; ensure the correct etiology is documented.
  • In complex cases, consider the patient's overall cardiac function and any coexisting conditions.

Code Exclusions

Important Exclusions

  • Excludes conditions such as mitral valve disease (I34) and tricuspid valve disease (I36).
  • Alternative codes for excluded conditions include I34.1 for mitral valve stenosis.
  • Conditions are excluded due to differing pathophysiology and treatment approaches.
  • Common mistakes include using aortic valve codes for mitral or tricuspid valve conditions.
  • Related but distinct conditions include aortic aneurysms and other structural heart defects.

Related ICD-10 Codes

Primary Codes
I35.0
Aortic stenosis
I35.1
Aortic regurgitation
Q23.81
Congenital aortic valve disease
Ancillary Codes
I50.9
Differential Codes
I06.0
I06.1
I35.0

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Cardiology

Specialty Applications

  • Applies to patients with diagnosed aortic valve disease, including stenosis and regurgitation.
  • Patient populations include older adults, those with congenital heart defects, and individuals with rheumatic fever history.
  • Clinical settings include outpatient cardiology clinics, inpatient hospital settings, and emergency departments.
  • Specialty-specific applications are relevant in cardiology, cardiac surgery, and interventional cardiology.
  • Treatment contexts include surgical interventions, catheter-based therapies, and medical management.

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Template 1

Template: 'Patient diagnosed with aortic stenosis based on echocardiographic findings showing a peak gradient of [value].'

Template 2

Template: 'Clinical presentation consistent with aortic regurgitation including symptoms of dyspnea and fatigue.'

Template 3

Template: 'Diagnostic criteria for aortic valve disease met as evidenced by echocardiogram showing [specific findings].'

Template 4

Template: 'Treatment plan initiated for aortic stenosis with surgical intervention planned for [date].'

Template 5

Template: 'Follow-up care for aortic regurgitation including monitoring parameters such as [specific parameters].'

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

What documentation is required for this diagnosis?

Documentation should include clinical findings, diagnostic test results, and treatment plans.

How does this differ from similar diagnoses?

Aortic valve disease specifically refers to issues with the aortic valve, while other valve diseases pertain to different valves.

What are common billing considerations?

Ensure that the diagnosis is clearly linked to the services provided to optimize reimbursement.

What procedures are typically associated?

Common procedures include aortic valve replacement, balloon valvuloplasty, and transcatheter aortic valve replacement (TAVR).

Are there any quality reporting implications?

Quality measures may include monitoring for heart failure symptoms and adherence to follow-up care protocols.