2025 ICD-10-CM code I09.1
Rheumatic diseases of the endocardium, valve unspecified. This includes chronic rheumatic endocarditis and valvulitis.
Medical necessity is established by the presence of signs, symptoms, and diagnostic findings consistent with rheumatic heart disease affecting an unspecified valve. The documentation should support the need for further evaluation and treatment, such as medication or valve surgery.
The clinician is responsible for documenting the diagnosis of rheumatic heart disease affecting an unspecified valve and ensuring appropriate diagnostic testing and treatment.
In simple words: This code indicates chronic heart valve damage due to rheumatic fever, where the specific valve isn't identified.
Rheumatic diseases of the endocardium affecting an unspecified valve. This encompasses chronic rheumatic endocarditis and valvulitis.Excludes: endocarditis, valve unspecified (I38)
Example 1: A patient with a history of rheumatic fever presents with symptoms of heart valve disease, such as shortness of breath and fatigue.Echocardiography reveals valvular dysfunction, but the specific valve affected is not clearly identified in the imaging report., A patient has documented rheumatic heart disease but the initial medical records do not specify which valve(s) are affected and current diagnostic tests are inconclusive., A patient with known rheumatic mitral valve disease develops new symptoms suggestive of involvement of another valve but further tests are not available or contraindicated to pinpoint the affected valve.
Documentation should include evidence of prior rheumatic fever, current symptoms of valvular disease, and results of diagnostic tests such as echocardiography.If the specific valve can be determined, a more specific code should be used.
** For accurate coding, utilize iFrameAI product for complete information regarding medical codes.
- Payment Status: Active
- Specialties:Cardiology, Internal Medicine, Family Medicine
- Place of Service:Inpatient Hospital, On Campus-Outpatient Hospital, Off Campus-Outpatient Hospital, Office, Independent Clinic, Federally Qualified Health Center