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 CodesI36

I36

Non-billable

Nonrheumatic tricuspid valve disorders

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

Code Description

ICD-10 I36 is a used to indicate a diagnosis of nonrheumatic tricuspid valve disorders.

Key Diagnostic Point:

Nonrheumatic tricuspid valve disorders encompass a range of conditions affecting the tricuspid valve, which is located between the right atrium and right ventricle of the heart. These disorders can include tricuspid regurgitation, stenosis, and other structural abnormalities that are not caused by rheumatic fever. Clinical presentation may vary from asymptomatic to symptoms of heart failure, such as fatigue, peripheral edema, and ascites. The anatomy involved includes the tricuspid valve leaflets, chordae tendineae, and papillary muscles, which can be affected by conditions such as dilated cardiomyopathy, pulmonary hypertension, or congenital defects. Disease progression can lead to right-sided heart failure if left untreated, as the heart struggles to pump effectively against increased pressure. Diagnostic considerations include echocardiography, which is essential for visualizing valve function and assessing the severity of the disorder. Other imaging modalities, such as MRI or CT scans, may be utilized for comprehensive evaluation.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

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

Audit Risk Factors

  • Common coding errors
  • Documentation gaps
  • Billing challenges

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

Cardiothoracic Surgery

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 tricuspid valve disorders can significantly impact patient quality of life and healthcare utilization patterns, particularly in populations with underlying heart disease. The prevalence of these conditions may increase with age and comorbidities such as pulmonary hypertension. Quality measures often focus on timely diagnosis and management to prevent progression to heart failure, highlighting the importance of effective coding and documentation in improving patient outcomes.

ICD-9 vs ICD-10

Nonrheumatic tricuspid valve disorders can significantly impact patient quality of life and healthcare utilization patterns, particularly in populations with underlying heart disease. The prevalence of these conditions may increase with age and comorbidities such as pulmonary hypertension. Quality measures often focus on timely diagnosis and management to prevent progression to heart failure, highlighting the importance of effective coding and documentation in improving patient outcomes.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the condition, the necessity for echocardiographic evaluations, and potential surgical interventions. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for procedures. Best practices include maintaining thorough clinical notes and ensuring that all relevant diagnostic tests are documented clearly to support the coding and billing process.

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 I36?

I36 covers nonrheumatic tricuspid valve disorders such as tricuspid regurgitation, tricuspid stenosis, and other structural abnormalities of the tricuspid valve that are not due to rheumatic fever. Diagnostic criteria typically include echocardiographic findings of valve dysfunction and associated clinical symptoms.

When should I36 be used instead of related codes?

I36 should be used when the tricuspid valve disorder is confirmed to be nonrheumatic in nature. It is important to differentiate it from rheumatic conditions (I34) and other heart valve disorders by ensuring that the clinical documentation specifies the etiology of the valve disorder.

What documentation supports I36?

Documentation supporting I36 should include echocardiographic reports indicating tricuspid valve dysfunction, clinical notes detailing symptoms and physical examination findings, and any relevant history of heart disease or associated conditions.