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ICD-10 Guide
DiagnosesArtificial Aortic Valve

Artificial Aortic Valve

ICD-10 Coding for Artificial Aortic Valve(Z95.2, T82.03XA)

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

Diagnosis Overview

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

Key Clinical Considerations:

  • Patients may present with symptoms such as dyspnea, chest pain, or palpitations, particularly during exertion.
  • Echocardiography may reveal abnormal valve function or structural changes in the heart.
  • Physical examination may show signs of heart failure, such as edema or abnormal heart sounds.
  • Imaging studies, such as echocardiograms or CT scans, may demonstrate the presence and function of the artificial aortic valve.
  • Severity may be assessed based on the degree of heart failure symptoms or echocardiographic findings.

Clinical Information

Clinical Criteria & Documentation Requirements

  • Medical records must document the presence of an artificial aortic valve and any related complications.
  • Specific terminology such as 'mechanical valve' or 'bioprosthetic valve' should be used to describe the type of artificial valve.
  • Examples include noting the date of valve replacement and any associated procedures.
  • Documentation must establish medical necessity for the procedure, including indications for valve replacement.
  • Quality measures may require documentation of follow-up care and monitoring of valve function.

Coding Guidelines

Usage Guidelines & Examples

  • Use Z95.2 when documenting a patient with an artificial aortic valve without complications.
  • Do not use this code for patients with a history of valve replacement but no current artificial valve present.
  • T82.03XA may be used for complications related to the artificial valve, such as malfunction or infection.
  • Common errors include using Z95.2 for patients with complications; ensure to document the correct scenario.
  • In complex cases, consider both Z95.2 and T82.03XA if complications are present.

Code Exclusions

Important Exclusions

  • Do not use Z95.2 for patients with native aortic valve disease or those without an artificial valve.
  • Alternative codes for excluded conditions include I35.0 for aortic stenosis and I35.9 for unspecified aortic valve disorders.
  • Conditions are excluded to ensure accurate representation of the patient's current status.
  • Common mistakes include misclassifying patients with native valve issues as having an artificial valve.
  • Related but distinct conditions include prosthetic valve endocarditis (I33.0) and other valve disorders.

Related ICD-10 Codes

Primary Codes
Z95.2
Presence of artificial heart valve
T82.03XA
Mechanical complication due to artificial heart valve
Ancillary Codes
T82.03XA
Differential Codes
I35.0
T82.6XXA

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Cardiology

Specialty Applications

  • This applies to patients with a history of aortic valve replacement due to stenosis or regurgitation.
  • Patient populations include adults, particularly those over 65, and individuals with a history of rheumatic heart disease.
  • Clinical settings include inpatient surgical units and outpatient cardiology clinics.
  • Specialty-specific applications are relevant in cardiology and cardiac surgery.
  • Treatment contexts include pre-operative assessments and post-operative follow-ups.

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 artificial aortic valve based on echocardiographic findings.'

Template 2

Template: 'Clinical presentation consistent with artificial aortic valve replacement including dyspnea on exertion.'

Template 3

Template: 'Diagnostic criteria met as evidenced by the presence of an artificial valve on imaging.'

Template 4

Template: 'Treatment plan initiated for artificial aortic valve with regular follow-up echocardiograms.'

Template 5

Template: 'Follow-up care for artificial aortic valve including monitoring for complications.'

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 the type of artificial valve, date of replacement, and any complications.

How does this differ from similar diagnoses?

Differentiation is based on the presence of an artificial valve versus native valve disease.

What are common billing considerations?

Ensure that the procedure is medically necessary and well-documented to optimize claims.

What procedures are typically associated?

Commonly associated procedures include valve replacement surgery and follow-up echocardiograms.

Are there any quality reporting implications?

Quality measures may include monitoring valve function and patient outcomes post-surgery.