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v1.0.0
ICD-10 Guide
DiagnosesNonrheumatic Mitral Valve Regurgitation

Nonrheumatic Mitral Valve Regurgitation

ICD-10 Coding for Nonrheumatic Mitral Valve Regurgitation(I34.0, I34.1)

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

Diagnosis Overview

What is Nonrheumatic Mitral Valve Regurgitation?
Essential facts and insights about Nonrheumatic Mitral Valve Regurgitation

Key Clinical Considerations:

  • Symptoms may include dyspnea, fatigue, palpitations, and orthopnea.
  • Echocardiography showing regurgitant flow and left atrial enlargement.
  • Physical exam may reveal a holosystolic murmur at the apex, possibly with radiation to the left axilla.

Clinical Information

Clinical Criteria & Documentation Requirements

  • Document patient history, symptoms, and physical exam findings.
  • Use specific terms like 'mitral valve insufficiency' or 'mitral regurgitation'.
  • Examples include detailed descriptions of echocardiographic findings and symptom severity.

Coding Guidelines

Usage Guidelines & Examples

  • Follow guidelines for distinguishing between rheumatic and nonrheumatic conditions.
  • Common errors include misclassifying the type of regurgitation.

Code Exclusions

Important Exclusions

  • Rheumatic heart disease, congenital heart defects, and other valvular diseases.
  • Alternative codes for other types of mitral valve disorders.

Related ICD-10 Codes

Primary Codes
I34.0
Nonrheumatic mitral valve insufficiency
Ancillary Codes
Z00.6
Differential Codes
I08.0
I05.1

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Cardiology

Specialty Applications

  • Adults with heart disease, particularly those with a history of ischemic heart disease.
  • Cardiology clinics, hospitals, and outpatient settings.

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

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

Documentation requirements?

Include detailed patient history, symptoms, and diagnostic test results.

Billing considerations?

Ensure accurate coding to reflect the severity and type of mitral valve regurgitation.