Nonrheumatic tricuspid (valve) insufficiency
ICD-10 I36.1 is a billable code used to indicate a diagnosis of nonrheumatic tricuspid (valve) insufficiency.
Nonrheumatic tricuspid valve insufficiency is a condition characterized by the inability of the tricuspid valve to close properly during systole, leading to the backflow of blood from the right ventricle into the right atrium. This condition can result from various etiologies, including degenerative changes, infective endocarditis, or structural abnormalities of the valve. Clinically, patients may present with symptoms such as fatigue, palpitations, peripheral edema, and signs of right heart failure. The tricuspid valve is located between the right atrium and right ventricle, and its dysfunction can lead to increased right atrial pressure and subsequent systemic venous congestion. Disease progression can vary; some patients may remain asymptomatic for years, while others may experience rapid deterioration requiring surgical intervention. Diagnostic considerations include echocardiography, which is essential for assessing valve morphology and function, as well as ruling out other causes of heart failure. Holter monitoring may also be employed to evaluate arrhythmias associated with tricuspid insufficiency.
Standard ICD-10-CM documentation requirements apply
Various clinical presentations within this specialty area
Follow specialty-specific billing guidelines
Standard ICD-10-CM documentation requirements apply
Various clinical presentations within this specialty area
Follow specialty-specific billing guidelines
I36.1 covers nonrheumatic tricuspid valve insufficiency, which may arise from degenerative changes, infective endocarditis, or congenital defects. It does not include rheumatic causes or other valve disorders.
I36.1 should be used when the tricuspid valve insufficiency is confirmed to be nonrheumatic in nature. If the insufficiency is due to rheumatic heart disease, I36.0 should be utilized.
Documentation should include a detailed clinical history, results from echocardiography demonstrating tricuspid valve insufficiency, and any relevant laboratory tests that rule out other conditions.
