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v1.0.0
ICD-10 Guide
ICD-10 CodesQ23.2

Q23.2

Billable

Congenital mitral stenosis

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 Q23.2 is a billable code used to indicate a diagnosis of congenital mitral stenosis.

Key Diagnostic Point:

Congenital mitral stenosis is a structural heart defect characterized by the narrowing of the mitral valve, which impedes blood flow from the left atrium to the left ventricle. This condition can lead to increased pressure in the left atrium, pulmonary congestion, and potential heart failure if not managed appropriately. It is often associated with other congenital heart defects, such as atrial septal defects or coarctation of the aorta. Symptoms may include difficulty breathing, fatigue, and poor growth in infants and children. Diagnosis typically involves echocardiography, which can visualize the mitral valve's structure and function. Treatment options may include medical management, surgical intervention, or balloon valvuloplasty, depending on the severity of the stenosis and the presence of other cardiac anomalies. Early detection and intervention are crucial for improving outcomes in affected individuals.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and severity of the condition
  • Potential for associated congenital heart defects
  • Need for detailed echocardiographic findings
  • Differentiation from acquired mitral stenosis

Audit Risk Factors

  • Inadequate documentation of symptoms and clinical findings
  • Failure to report associated congenital anomalies
  • Misclassification of congenital vs. acquired conditions
  • Lack of clarity in echocardiographic reports

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Pediatric documentation should include growth parameters, developmental milestones, and specific symptoms related to heart function.

Common Clinical Scenarios

Common scenarios include infants presenting with failure to thrive, respiratory distress, or heart murmurs detected during routine examinations.

Billing Considerations

Consideration must be given to the age of the patient and the potential for growth-related changes in symptoms and management.

Genetics

Documentation Requirements

Genetic documentation should include family history of congenital heart defects and any chromosomal abnormalities that may be associated.

Common Clinical Scenarios

Scenarios may involve genetic counseling for families with a history of congenital heart disease or syndromic presentations.

Billing Considerations

Genetic testing results should be documented clearly, especially if they relate to syndromes that include congenital heart defects.

Coding Guidelines

Inclusion Criteria

Use Q23.2 When
  • According to ICD
  • 10 coding guidelines, congenital conditions should be coded based on the specific anatomical and functional characteristics
  • Documentation must support the diagnosis, including imaging studies and clinical findings

Exclusion Criteria

Do NOT use Q23.2 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

93306CPT Code

Echocardiography, transthoracic, real-time with interpretation

Clinical Scenario

Used for initial diagnosis and ongoing monitoring of congenital mitral stenosis.

Documentation Requirements

Echocardiographic findings must be documented, including valve morphology and function.

Specialty Considerations

Pediatric echocardiography may require specialized training and interpretation.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the accuracy of data collection and reimbursement processes. The detailed codes facilitate better tracking of congenital heart defects and their outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the accuracy of data collection and reimbursement processes. The detailed codes facilitate better tracking of congenital heart defects and their outcomes.

Reimbursement & Billing Impact

reimbursement processes. The detailed codes facilitate better tracking of congenital heart defects and their outcomes.

Resources

Clinical References

  • •
    American Academy of Pediatrics - Congenital Heart Disease

Coding & Billing References

  • •
    American Academy of Pediatrics - Congenital Heart Disease

Frequently Asked Questions

What are the common symptoms of congenital mitral stenosis?

Common symptoms include difficulty breathing, fatigue, poor growth, and heart murmurs. Symptoms may vary based on the severity of the stenosis and the age of the patient.