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ICD-10 Guide
ICD-10 CodesI37

I37

Non-billable

Nonrheumatic pulmonary valve disorders

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

Code Description

ICD-10 I37 is a used to indicate a diagnosis of nonrheumatic pulmonary valve disorders.

Key Diagnostic Point:

Nonrheumatic pulmonary valve disorders encompass a range of conditions affecting the pulmonary valve, which is responsible for regulating blood flow from the right ventricle to the pulmonary artery. These disorders can include pulmonary valve stenosis, regurgitation, and atresia, often resulting from congenital defects or degenerative changes. Clinically, patients may present with symptoms such as dyspnea, fatigue, and syncope, particularly during exertion. The anatomy involved includes the right ventricle, pulmonary valve, and pulmonary artery, with dysfunction potentially leading to right ventricular hypertrophy and heart failure over time. Disease progression can vary, with some patients remaining asymptomatic for years, while others may experience rapid deterioration necessitating surgical intervention. Diagnostic considerations include echocardiography, which is essential for assessing valve morphology and function, as well as cardiac MRI or CT for detailed anatomical evaluation. Holter monitoring may also be indicated to assess for arrhythmias associated with valve disorders.

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 pulmonary valve disorders can significantly impact patient quality of life and healthcare utilization, particularly in cases requiring surgical intervention. These conditions may lead to increased hospital admissions and long-term management needs. Understanding the epidemiology of these disorders is crucial for population health initiatives, as timely diagnosis and treatment can improve outcomes and reduce healthcare costs.

ICD-9 vs ICD-10

Nonrheumatic pulmonary valve disorders can significantly impact patient quality of life and healthcare utilization, particularly in cases requiring surgical intervention. These conditions may lead to increased hospital admissions and long-term management needs. Understanding the epidemiology of these disorders is crucial for population health initiatives, as timely diagnosis and treatment can improve outcomes and reduce healthcare costs.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the condition and the necessity for surgical intervention. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for procedures. Coders should ensure that all relevant clinical data is included in the medical record to support the diagnosis and any treatments provided, adhering to payer-specific guidelines.

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 I37?

I37 covers nonrheumatic pulmonary valve disorders, including pulmonary valve stenosis, regurgitation, and atresia. These conditions can arise from congenital anomalies or degenerative changes and are diagnosed based on clinical symptoms and imaging studies.

When should I37 be used instead of related codes?

I37 should be used when the pulmonary valve disorder is confirmed to be nonrheumatic in nature. If the disorder is due to rheumatic heart disease, codes from the I34 series should be utilized instead.

What documentation supports I37?

Documentation should include clinical findings, imaging results (such as echocardiograms), and any relevant history of congenital heart disease or previous interventions. Detailed notes on symptoms and functional status are also essential.