ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesI06.2

I06.2

Billable

Rheumatic aortic stenosis with insufficiency

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

Code Description

ICD-10 I06.2 is a billable code used to indicate a diagnosis of rheumatic aortic stenosis with insufficiency.

Key Diagnostic Point:

Rheumatic aortic stenosis with insufficiency is a heart condition resulting from rheumatic fever, which can lead to inflammation and scarring of the heart valves. This specific condition involves both narrowing (stenosis) and leakage (insufficiency) of the aortic valve, which impairs normal blood flow from the heart to the aorta. Clinically, patients may present with symptoms such as dyspnea, fatigue, palpitations, and signs of heart failure. The anatomy involved includes the left ventricle, aortic valve, and aorta. Disease progression can lead to significant hemodynamic changes, including left ventricular hypertrophy and heart failure if left untreated. Diagnostic considerations include echocardiography to assess valve morphology and function, as well as Doppler studies to evaluate the severity of stenosis and regurgitation. Early diagnosis and management are crucial to prevent complications such as arrhythmias and pulmonary hypertension.

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 documentation of both stenosis and insufficiency.

Audit Risk Factors

  • Common coding errors: Misidentification of stenosis versus insufficiency.
  • Documentation gaps: Incomplete clinical notes or lack of imaging studies.
  • Billing challenges: Potential denials due to insufficient documentation supporting the dual 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 ICD-10 Codes

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 stenosis with insufficiency significantly impacts clinical outcomes, as it can lead to heart failure and increased morbidity. Population health is affected by the prevalence of rheumatic heart disease, particularly in developing regions. Quality measures focus on timely diagnosis and management to improve patient outcomes. Healthcare utilization patterns may reflect increased hospital admissions and surgical interventions, highlighting the need for effective preventive strategies and management protocols.

ICD-9 vs ICD-10

Rheumatic aortic stenosis with insufficiency significantly impacts clinical outcomes, as it can lead to heart failure and increased morbidity. Population health is affected by the prevalence of rheumatic heart disease, particularly in developing regions. Quality measures focus on timely diagnosis and management to improve patient outcomes. Healthcare utilization patterns may reflect increased hospital admissions and surgical interventions, highlighting the need for effective preventive strategies and management protocols.

Reimbursement & Billing Impact

Reimbursement considerations include the severity of the condition and the necessity for surgical intervention. Common denials may arise from inadequate documentation or failure to demonstrate medical necessity for procedures related to the condition. Best practices include ensuring that all clinical notes, imaging studies, and treatment plans are thoroughly documented and aligned with coding guidelines to support claims.

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 I06.2?

I06.2 specifically covers rheumatic aortic stenosis with associated aortic regurgitation, which is characterized by both narrowing of the aortic valve and backward flow of blood into the left ventricle.

When should I06.2 be used instead of related codes?

I06.2 should be used when both aortic stenosis and insufficiency are present, as indicated by echocardiographic findings. If only stenosis or insufficiency is present, the appropriate separate codes should be utilized.

What documentation supports I06.2?

Documentation must include a thorough clinical evaluation, echocardiographic reports detailing the severity of stenosis and regurgitation, and any relevant laboratory findings that support the diagnosis of rheumatic heart disease.