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ICD-10 Guide
ICD-10 CodesChapter 9: Diseases of the circulatory systemI06

I06

Non-billable

Rheumatic aortic valve diseases

Chapter 9:Diseases of the circulatory system

BILLABLE STATUSNo
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 I06 is a used to indicate a diagnosis of rheumatic aortic valve diseases.

Key Diagnostic Point:

Rheumatic aortic valve diseases encompass a range of conditions resulting from rheumatic fever, which can lead to inflammation and scarring of the aortic valve. Clinically, patients may present with symptoms such as dyspnea, fatigue, palpitations, and chest pain, often exacerbated by exertion. The aortic valve, located between the left ventricle and the aorta, is crucial for proper blood flow from the heart to the body. Over time, rheumatic aortic valve disease can progress to aortic stenosis or regurgitation, leading to significant hemodynamic changes and heart failure if left untreated. Diagnosis typically involves a thorough clinical evaluation, echocardiography to assess valve structure and function, and possibly cardiac catheterization for further assessment. Early detection and management are essential to prevent complications, including arrhythmias and endocarditis, which can arise from the altered hemodynamics associated with valve dysfunction.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires echocardiographic evaluation and clinical correlation.
  • Treatment complexity: May involve medical management, surgical intervention, or valve replacement.
  • Documentation requirements: Detailed clinical history and diagnostic imaging reports are essential.
  • Coding specificity: Requires precise coding to differentiate between types of valve disease.

Audit Risk Factors

  • Common coding errors: Misclassification of valve disease type.
  • Documentation gaps: Incomplete clinical notes or missing echocardiogram results.
  • Billing challenges: Denials due to lack of supporting documentation for the diagnosis.

Specialty Focus

Medical Specialties

Cardiology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Internal Medicine

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Rheumatic aortic valve diseases significantly impact population health, particularly in regions with high rates of rheumatic fever. These conditions can lead to increased healthcare utilization due to hospitalizations for heart failure and surgical interventions. Quality measures focus on timely diagnosis and management to prevent complications. Epidemiologically, the prevalence of rheumatic heart disease remains a concern, particularly in developing countries, highlighting the need for preventive measures and effective treatment strategies.

ICD-9 vs ICD-10

Rheumatic aortic valve diseases significantly impact population health, particularly in regions with high rates of rheumatic fever. These conditions can lead to increased healthcare utilization due to hospitalizations for heart failure and surgical interventions. Quality measures focus on timely diagnosis and management to prevent complications. Epidemiologically, the prevalence of rheumatic heart disease remains a concern, particularly in developing countries, highlighting the need for preventive measures and effective treatment strategies.

Reimbursement & Billing Impact

Reimbursement considerations include the necessity of echocardiographic evaluations and potential surgical interventions. Common denials may arise from insufficient documentation linking the diagnosis to clinical symptoms or from coding errors related to valve type. Best practices include ensuring all clinical notes are complete, including the rationale for any surgical procedures, and confirming that all coding aligns with the documentation provided.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for I00-I99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for I00-I99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by I06?

I06 covers rheumatic aortic stenosis and rheumatic aortic regurgitation, both resulting from rheumatic fever. Diagnostic criteria include clinical history of rheumatic fever, echocardiographic evidence of valve dysfunction, and associated symptoms.

When should I06 be used instead of related codes?

I06 should be used specifically when the aortic valve disease is attributed to rheumatic fever. If the valve disease is due to degenerative or other causes, different codes such as I35 (Aortic valve disorders) should be considered.

What documentation supports I06?

Documentation should include a detailed clinical history, evidence of prior rheumatic fever, echocardiographic findings indicating aortic valve involvement, and any relevant laboratory tests that support the diagnosis.