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ICD-10 Guide
ICD-10 CodesI35

I35

Non-billable

Nonrheumatic aortic valve disorders

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

Code Description

ICD-10 I35 is a used to indicate a diagnosis of nonrheumatic aortic valve disorders.

Key Diagnostic Point:

Nonrheumatic aortic valve disorders encompass a range of conditions affecting the aortic valve that are not caused by rheumatic fever. These disorders can include aortic stenosis, aortic regurgitation, and aortic valve insufficiency. Clinically, patients may present with symptoms such as dyspnea, angina, syncope, or heart failure, depending on the severity of the valve dysfunction. The aortic valve is located between the left ventricle and the aorta, and its proper function is crucial for maintaining adequate blood flow from the heart to the systemic circulation. Disease progression can lead to significant hemodynamic changes, resulting in left ventricular hypertrophy and eventual heart failure if left untreated. Diagnostic considerations include echocardiography, which is the primary imaging modality used to assess valve structure and function, as well as cardiac catheterization in certain cases to evaluate the severity of the condition. Regular monitoring and timely intervention are essential to manage these disorders effectively.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors
  • Documentation gaps
  • Billing challenges

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

Cardiothoracic Surgery

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

Nonrheumatic aortic valve disorders significantly impact patient quality of life and can lead to increased healthcare utilization due to complications such as heart failure. These conditions are prevalent in older populations, contributing to the overall burden of cardiovascular diseases. Effective management and timely intervention can improve outcomes and reduce hospitalizations, highlighting the importance of early diagnosis and appropriate coding in population health strategies.

ICD-9 vs ICD-10

Nonrheumatic aortic valve disorders significantly impact patient quality of life and can lead to increased healthcare utilization due to complications such as heart failure. These conditions are prevalent in older populations, contributing to the overall burden of cardiovascular diseases. Effective management and timely intervention can improve outcomes and reduce hospitalizations, highlighting the importance of early diagnosis and appropriate coding in population health strategies.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the condition, the necessity of surgical intervention, and the use of diagnostic imaging. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for procedures. Best practices include ensuring that all clinical findings are clearly documented and that coding accurately reflects the patient's diagnosis and treatment plan.

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 I35?

I35 covers nonrheumatic aortic valve disorders, including aortic stenosis, aortic regurgitation, and aortic valve insufficiency. These conditions may arise from degenerative changes, congenital defects, or other non-inflammatory causes.

When should I35 be used instead of related codes?

I35 should be used when the aortic valve disorder is specifically nonrheumatic in nature. If the condition is due to rheumatic fever, the appropriate code would be I34. Accurate differentiation is crucial for proper coding and treatment planning.

What documentation supports I35?

Documentation should include clinical findings from physical examinations, echocardiographic results, and any relevant imaging studies. Detailed notes on symptoms, functional status, and treatment plans are also essential to support the use of I35.