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ICD-10 Guide
ICD-10 CodesI34

I34

Non-billable

Nonrheumatic mitral valve disorders

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

Code Description

ICD-10 I34 is a used to indicate a diagnosis of nonrheumatic mitral valve disorders.

Key Diagnostic Point:

Nonrheumatic mitral valve disorders encompass a range of conditions affecting the mitral valve, which is located between the left atrium and left ventricle of the heart. These disorders can include mitral valve prolapse, mitral regurgitation, and mitral stenosis, among others. Clinically, patients may present with symptoms such as dyspnea, palpitations, fatigue, and in severe cases, heart failure. The anatomy involved includes the mitral valve leaflets, chordae tendineae, and papillary muscles, which work together to ensure proper blood flow from the left atrium to the left ventricle. Disease progression can vary; some patients may remain asymptomatic for years, while others may experience rapid deterioration requiring surgical intervention. Diagnostic considerations include echocardiography, which is the primary imaging modality used to assess mitral valve structure and function, along with clinical evaluation and history taking to identify symptoms and risk factors. Regular monitoring and follow-up are crucial for managing these conditions effectively.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires echocardiographic assessment and clinical correlation.
  • Treatment complexity: Management may involve medical therapy or surgical options.
  • Documentation requirements: Detailed clinical notes and imaging reports are essential.
  • Coding specificity: Requires accurate identification of the specific mitral valve disorder.

Audit Risk Factors

  • Common coding errors: Misclassification of the type of mitral valve disorder.
  • Documentation gaps: Incomplete clinical notes or lack of imaging results.
  • Billing challenges: Potential denials due to insufficient documentation or coding errors.

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 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

Nonrheumatic mitral valve disorders significantly impact patient quality of life and can lead to serious complications if left untreated. They contribute to a substantial burden on healthcare systems due to the need for ongoing monitoring, potential surgical interventions, and management of heart failure symptoms. Understanding the epidemiology of these conditions helps in developing targeted public health strategies and improving patient outcomes through early detection and effective management.

ICD-9 vs ICD-10

Nonrheumatic mitral valve disorders significantly impact patient quality of life and can lead to serious complications if left untreated. They contribute to a substantial burden on healthcare systems due to the need for ongoing monitoring, potential surgical interventions, and management of heart failure symptoms. Understanding the epidemiology of these conditions helps in developing targeted public health strategies and improving patient outcomes through early detection and effective management.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the condition and the treatments provided, whether medical management or surgical intervention. Common denials may arise from insufficient documentation or failure to provide necessary imaging results. Coders should ensure that all relevant clinical information is included in the medical record to support the diagnosis and any procedures performed. Best practices include regular training on coding updates and maintaining clear communication with healthcare providers to ensure accurate coding.

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 I34?

I34 covers nonrheumatic mitral valve disorders such as mitral valve prolapse, nonrheumatic mitral regurgitation, and nonrheumatic mitral stenosis. Each condition has specific diagnostic criteria based on echocardiographic findings and clinical symptoms.

When should I34 be used instead of related codes?

I34 should be used when the mitral valve disorder is confirmed to be nonrheumatic. If the disorder is due to rheumatic fever or other rheumatic conditions, codes from the I35 category should be utilized.

What documentation supports I34?

Documentation for I34 should include detailed clinical notes outlining the patient's symptoms, history, and results from echocardiography or other imaging studies that confirm the diagnosis of a nonrheumatic mitral valve disorder.