2025 ICD-10-CM code I34.1
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Cardiovascular - Other forms of heart disease Diseases of the circulatory system (I00-I99) Feed
Nonrheumatic mitral valve prolapse, also known as floppy mitral valve syndrome.
Modifiers may be used in conjunction with CPT codes for procedures related to the treatment of mitral valve prolapse.These modifiers would clarify the services provided and would be dependent on the specific procedural codes.
Medical necessity for treatment is established based on the presence of symptoms and/or significant hemodynamic compromise due to mitral valve prolapse and regurgitation.The severity of the condition will dictate the necessity for intervention (e.g., surgery).
The clinical responsibility involves diagnosing the mitral valve prolapse through physical examination, echocardiography, and other relevant diagnostic tests. Management may involve monitoring, medication (if needed for symptoms), and referral to a cardiologist for further evaluation and potential interventions if the prolapse is severe.
In simple words: This code describes a problem with the mitral valve in the heart. The mitral valve's flaps don't close properly, causing them to bulge backward. This isn't caused by rheumatic fever.Some people have no symptoms, while others might experience heart palpitations, shortness of breath, or chest pain.
I34.1, Nonrheumatic mitral (valve) prolapse, signifies a condition where the mitral valve leaflets prolapse or bulge backward into the left atrium during ventricular systole. This is a non-rheumatic condition, excluding those caused by rheumatic fever.The prolapse may be asymptomatic or cause symptoms like palpitations, shortness of breath, chest pain, and lightheadedness. Severity varies widely.
Example 1: A 30-year-old female presents with palpitations and occasional chest discomfort.Echocardiography reveals mitral valve prolapse.No intervention is required at this time; the patient is scheduled for follow-up monitoring., A 60-year-old male experiences recurrent episodes of shortness of breath.Echocardiography shows severe mitral valve prolapse with mild mitral regurgitation.The patient undergoes mitral valve repair surgery., A 45-year-old female with a history of mitral valve prolapse is admitted to the hospital with worsening shortness of breath and lightheadedness.Echocardiography confirms significant mitral regurgitation.The patient requires medication management for heart failure.
* Detailed patient history including symptoms, duration, and severity.* Physical examination findings.* Results of echocardiography (including valve morphology, degree of prolapse, and presence of regurgitation).* Electrocardiogram (ECG) findings if indicated.* Any other relevant diagnostic testing (e.g., cardiac catheterization).* Treatment plan and response to treatment.
** This code is for non-rheumatic mitral valve prolapse.Ensure that the cause of the prolapse is accurately identified to avoid miscoding.The severity of mitral regurgitation, if present, should also be documented and considered when determining appropriate codes for any associated treatment.
- Revenue Code: Revenue codes will vary depending on the services provided and the payer.
- RVU: RVUs are not applicable to ICD-10 codes.Reimbursement is determined by the procedures and services provided, which would use CPT codes with associated RVUs.
- Global Days: Not applicable to ICD-10 codes.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Fee Schedule: Not applicable to ICD-10 codes.
- Specialties:Cardiology
- Place of Service:Office, Hospital (Inpatient or Outpatient), Ambulatory Surgical Center