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ICD-10 Guide
ICD-10 CodesI06.8

I06.8

Billable

Other rheumatic aortic valve diseases

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 I06.8 is a billable code used to indicate a diagnosis of other rheumatic aortic valve diseases.

Key Diagnostic Point:

Other rheumatic aortic valve diseases encompass a variety of conditions affecting the aortic valve that are secondary to rheumatic fever. Clinically, patients may present with symptoms such as dyspnea, fatigue, palpitations, and chest pain, often exacerbated by physical exertion. The aortic valve, located between the left ventricle and the aorta, is crucial for proper blood flow from the heart to the body. Rheumatic aortic valve diseases can lead to stenosis or regurgitation, resulting in significant hemodynamic changes and potential heart failure if left untreated. Disease progression may vary, with some patients experiencing gradual deterioration of valve function over years, while others may have more rapid declines. Diagnosis typically involves echocardiography to assess valve structure and function, along with clinical evaluation of symptoms and history of rheumatic fever. Additional imaging or cardiac catheterization may be warranted in complex cases to evaluate the severity of the disease and guide treatment options.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors include misclassification of valve disease types.
  • Documentation gaps may arise from insufficient patient history regarding rheumatic fever.
  • Billing challenges can occur if the relationship between rheumatic fever and valve disease is not clearly established.

Specialty Focus

Medical Specialties

Cardiology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Rheumatology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Rheumatic aortic valve diseases significantly impact population health, particularly in regions with high rates of rheumatic fever. These conditions can lead to increased healthcare utilization due to hospitalizations for heart failure or surgical interventions. Quality measures focus on timely diagnosis and management to prevent complications. Epidemiologically, the prevalence of rheumatic heart disease remains a concern, especially in developing countries, highlighting the need for improved preventive strategies and access to care.

ICD-9 vs ICD-10

Rheumatic aortic valve diseases significantly impact population health, particularly in regions with high rates of rheumatic fever. These conditions can lead to increased healthcare utilization due to hospitalizations for heart failure or surgical interventions. Quality measures focus on timely diagnosis and management to prevent complications. Epidemiologically, the prevalence of rheumatic heart disease remains a concern, especially in developing countries, highlighting the need for improved preventive strategies and access to care.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the diagnosis is clearly linked to the treatment provided. Common denials may arise from insufficient documentation of the rheumatic history or failure to demonstrate medical necessity for procedures. Best practices include maintaining detailed clinical notes and ensuring that all relevant diagnostic tests are documented and coded accurately to support the claims.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for I00-I99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for I00-I99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by I06.8?

I06.8 covers various rheumatic aortic valve diseases, including rheumatic aortic stenosis and regurgitation, which are sequelae of rheumatic fever. These conditions are characterized by structural changes to the aortic valve due to inflammatory processes.

When should I06.8 be used instead of related codes?

I06.8 should be used when the aortic valve disease is specifically attributed to rheumatic fever. If the valve disease is due to degenerative changes or other etiologies, different codes such as I35.0 (non-rheumatic aortic stenosis) should be utilized.

What documentation supports I06.8?

Documentation should include a confirmed history of rheumatic fever, clinical symptoms, echocardiographic findings indicating aortic valve involvement, and any relevant laboratory tests that support the diagnosis of rheumatic heart disease.