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ICD-10 Guide
DiagnosesAortic Valve Stenosis

Aortic Valve Stenosis

ICD-10 Coding for Aortic Valve Stenosis(I06.0, I35.0, I08.0, Q23.1)

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

Diagnosis Overview

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

Key Clinical Considerations:

  • Patients may present with symptoms such as dyspnea on exertion, angina, or syncope.
  • Echocardiography may reveal aortic valve area <1.0 cm² and increased left ventricular outflow tract gradient.
  • Physical examination may show a characteristic 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 enlargement.
  • Severity can be 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 valve stenosis' and include severity descriptors.
  • Examples include: 'Patient presents with severe aortic stenosis as evidenced by echocardiogram findings.'
  • Medical necessity must be established through documentation of symptoms and need for intervention.
  • Quality measures may include documentation of echocardiographic findings and treatment plans.

Coding Guidelines

Usage Guidelines & Examples

  • Use I06.0 for congenital aortic valve stenosis, I35.0 for acquired aortic valve stenosis, and I08.0 for aortic stenosis due to rheumatic heart disease.
  • Do not use these codes for non-stenotic aortic valve conditions or other valvular heart diseases.
  • I35.0 is distinct from I08.0 as it pertains to degenerative changes rather than rheumatic causes.
  • Common errors include misclassifying the type of stenosis or failing to document severity.
  • In complex cases, ensure to document all contributing factors and the specific type of stenosis.

Code Exclusions

Important Exclusions

  • Excludes conditions such as aortic regurgitation or non-stenotic aortic valve abnormalities.
  • Alternative codes for excluded conditions include I35.1 for aortic regurgitation.
  • Conditions are excluded as they represent different pathophysiological processes.
  • Common mistakes include coding aortic regurgitation as stenosis without proper documentation.
  • Related conditions include mitral valve stenosis and tricuspid valve disorders.

Related ICD-10 Codes

Primary Codes
I35.0
Aortic valve stenosis, acquired
I06.0
Congenital aortic valve stenosis
Ancillary Codes
Z95.2
Differential Codes
I35.0
I06.0

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Cardiology

Specialty Applications

  • Applies to patients with aortic valve stenosis, both congenital and acquired.
  • Common in older adults, particularly those with a history of rheumatic fever or degenerative changes.
  • Clinical settings include outpatient cardiology clinics, inpatient hospital settings, and emergency departments.
  • Relevant for cardiology specialists and primary care providers managing heart conditions.
  • Used in treatment contexts involving surgical intervention or monitoring of disease progression.

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 valve stenosis based on echocardiographic findings.'

Template 2

Template: 'Clinical presentation consistent with aortic valve stenosis including dyspnea and exertional angina.'

Template 3

Template: 'Diagnostic criteria for aortic valve stenosis met as evidenced by a valve area <1.0 cm².'

Template 4

Template: 'Treatment plan initiated for aortic valve stenosis with surgical intervention recommended.'

Template 5

Template: 'Follow-up care for aortic valve stenosis including monitoring of left ventricular function.'

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?

Documentation must include clinical symptoms, echocardiographic findings, and treatment plans.

How does this differ from similar diagnoses?

Aortic valve stenosis is characterized by narrowing of the aortic valve, while aortic regurgitation involves backflow.

What are common billing considerations?

Ensure accurate coding of severity and associated procedures to optimize reimbursement.

What procedures are typically associated?

Common procedures include aortic valve replacement and balloon valvuloplasty.

Are there any quality reporting implications?

Quality measures may include tracking outcomes of surgical interventions and follow-up care.