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v1.0.0
ICD-10 Guide
DiagnosesAortic Stenosis

Aortic Stenosis

ICD-10 Coding for Aortic Stenosis(I35.0, I06.0, Q23.1)

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

Diagnosis Overview

What is Aortic Stenosis?
Essential facts and insights about Aortic Stenosis

Key Clinical Considerations:

  • Patients may present with symptoms such as dyspnea on exertion, angina, or syncope.
  • Echocardiography typically shows aortic valve area less than 1.0 cm² and increased left ventricular outflow tract gradient.
  • Physical examination may reveal a systolic ejection murmur best heard at the right second intercostal space.
  • Imaging findings may include left ventricular hypertrophy on echocardiogram or chest X-ray showing cardiac silhouette changes.
  • Severity is often classified as mild, moderate, or severe based on valve area and pressure gradients.

Clinical Information

Clinical Criteria & Documentation Requirements

  • Document the presence of symptoms, physical exam findings, and diagnostic test results.
  • Use specific terminology such as 'aortic stenosis' and include severity descriptors.
  • Examples include: 'Patient diagnosed with severe aortic stenosis based on echocardiographic findings.'
  • Document medical necessity for procedures like valve replacement or balloon valvuloplasty.
  • Quality measures may include documentation of symptom assessment and follow-up care plans.

Coding Guidelines

Usage Guidelines & Examples

  • Use I35.0 for aortic stenosis due to calcific degeneration in older adults.
  • Do not use this code for aortic regurgitation or other valvular heart diseases.
  • Compare with I06.0 (rheumatic aortic stenosis) and Q23.1 (congenital aortic stenosis) for specific etiologies.
  • Common errors include misclassifying the type of stenosis or failing to document severity.
  • In complex cases, ensure to document all contributing factors and co-morbidities.

Code Exclusions

Important Exclusions

  • Exclude codes for aortic regurgitation (I35.1) and other valvular heart diseases.
  • Use I06.0 for rheumatic causes and Q23.1 for congenital cases instead.
  • Conditions are excluded to ensure accurate representation of the specific pathology.
  • Common mistakes include using aortic stenosis codes for patients with mixed valvular disease.
  • Related conditions include mitral stenosis and other structural heart diseases.

Related ICD-10 Codes

Primary Codes
I35.0
Aortic stenosis due to calcific degeneration
I06.0
Rheumatic aortic stenosis
Ancillary Codes
Z95.0
I08.0
Differential Codes
I06.0
I35.0

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Cardiology

Specialty Applications

  • Applies to patients with aortic stenosis, particularly in older adults.
  • Risk factors include age, history of rheumatic fever, and congenital heart defects.
  • Clinical settings include outpatient cardiology clinics, inpatient hospital settings, and emergency departments.
  • Specialty-specific applications are primarily in cardiology and cardiac surgery.
  • Treatment contexts include surgical intervention, transcatheter aortic valve replacement (TAVR), and medical management.

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

Template 1

Template: 'Patient diagnosed with aortic stenosis based on echocardiographic findings.'

Template 2

Template: 'Clinical presentation consistent with aortic stenosis including dyspnea and fatigue.'

Template 3

Template: 'Diagnostic criteria met as evidenced by echocardiogram showing valve area < 1.0 cm².'

Template 4

Template: 'Treatment plan initiated for aortic stenosis with referral for TAVR evaluation.'

Template 5

Template: 'Follow-up care for aortic stenosis including monitoring of symptoms and echocardiogram.'

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

What documentation is required for this diagnosis?

Document clinical findings, diagnostic tests, and treatment plans.

How does this differ from similar diagnoses?

Differentiation is based on etiology, severity, and associated symptoms.

What are common billing considerations?

Ensure medical necessity is documented for procedures related to aortic stenosis.

What procedures are typically associated?

CPT codes for echocardiography, TAVR, and surgical valve replacement.

Are there any quality reporting implications?

Quality measures may include symptom assessment and follow-up care documentation.