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v1.0.0
ICD-10 Guide
DiagnosesMitral Valve Replacement

Mitral Valve Replacement

ICD-10 Coding for Mitral Valve Replacement(Z95.2, Z98.890)

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

Diagnosis Overview

What is Mitral Valve Replacement?
Essential facts and insights about Mitral Valve Replacement

Key Clinical Considerations:

  • Dyspnea on exertion
  • Fatigue
  • Palpitations
  • Auscultation reveals a holosystolic murmur
  • Echocardiogram shows mitral regurgitation or stenosis

Clinical Information

Clinical Criteria & Documentation Requirements

  • Patient history and physical exam findings
  • Indications for surgery
  • Preoperative and postoperative assessments
  • Informed consent documentation
  • Specific terminology: 'mitral valve replacement', 'mechanical valve', 'bioprosthetic valve'

Coding Guidelines

Usage Guidelines & Examples

  • Ensure accurate coding for valve type to avoid denials.
  • Common errors include using outdated codes or incorrect valve descriptions.

Code Exclusions

Important Exclusions

  • Rheumatic heart disease
  • Congenital heart defects
  • Alternative codes for valve repair

Related ICD-10 Codes

Primary Codes
I34.0
Nonrheumatic mitral (valve) insufficiency
I35.0
Nonrheumatic mitral (valve) stenosis
Z95.2
Presence of mitral valve replacement
Ancillary Codes
I34.0
Differential Codes
Z98.890
Z95.2

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Cardiothoracic Surgery

Specialty Applications

  • Patients with severe mitral valve disease
  • Cardiothoracic surgical settings

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

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

Documentation requirements?

Include detailed patient history, surgical indications, and valve type.

Billing considerations?

Ensure correct coding of both diagnosis and procedure; verify insurance coverage for valve types.