ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesI07.0

I07.0

Billable

Rheumatic tricuspid stenosis

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

Code Description

ICD-10 I07.0 is a billable code used to indicate a diagnosis of rheumatic tricuspid stenosis.

Key Diagnostic Point:

Rheumatic tricuspid stenosis is a condition characterized by the narrowing of the tricuspid valve, which impedes blood flow from the right atrium to the right ventricle. This condition often arises as a sequela of rheumatic fever, a complication of untreated streptococcal throat infections. Clinically, patients may present with symptoms such as fatigue, palpitations, peripheral edema, and signs of right heart failure. The anatomy involved includes the tricuspid valve, which consists of three leaflets that may become thickened and calcified due to chronic inflammation. Disease progression can lead to significant hemodynamic changes, including elevated right atrial pressure and reduced cardiac output. Diagnostic considerations include echocardiography, which is essential for assessing valve morphology and function, as well as cardiac catheterization in complex cases. Early diagnosis and management are crucial to prevent complications such as atrial fibrillation and systemic embolization.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical correlation.
  • Treatment complexity: May involve medical management or surgical intervention.
  • Documentation requirements: Detailed clinical history and diagnostic imaging reports needed.
  • Coding specificity: Requires precise coding to differentiate from other valvular diseases.

Audit Risk Factors

  • Common coding errors: Misidentification of rheumatic vs. degenerative stenosis.
  • Documentation gaps: Incomplete clinical history or lack of imaging reports.
  • Billing challenges: Potential denials due to insufficient documentation of severity.

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

Internal Medicine

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 tricuspid stenosis has significant clinical implications, particularly in populations with a history of rheumatic fever. It can lead to increased healthcare utilization due to complications such as heart failure and arrhythmias. Quality measures focus on early diagnosis and management to improve patient outcomes. Epidemiologically, the condition is more prevalent in developing regions where rheumatic fever remains common, highlighting the need for preventive strategies.

ICD-9 vs ICD-10

Rheumatic tricuspid stenosis has significant clinical implications, particularly in populations with a history of rheumatic fever. It can lead to increased healthcare utilization due to complications such as heart failure and arrhythmias. Quality measures focus on early diagnosis and management to improve patient outcomes. Epidemiologically, the condition is more prevalent in developing regions where rheumatic fever remains common, highlighting the need for preventive strategies.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the severity of the condition and the treatment provided. Common denials may arise from inadequate documentation or failure to demonstrate medical necessity for procedures. Best practices include ensuring all relevant clinical data is included in the medical record and verifying insurance coverage for specific treatments.

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 I07.0?

I07.0 specifically covers rheumatic tricuspid stenosis, which is a result of rheumatic fever. It is important to differentiate this from other forms of tricuspid stenosis, such as congenital or degenerative causes.

When should I07.0 be used instead of related codes?

I07.0 should be used when the stenosis is specifically due to rheumatic heart disease. If the stenosis is due to other causes, such as degenerative changes or congenital defects, other codes should be selected.

What documentation supports I07.0?

Documentation should include a detailed clinical history of rheumatic fever, echocardiographic findings indicating tricuspid stenosis, and any relevant laboratory results that support the diagnosis.