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2025 ICD-10-CM code I35

Nonrheumatic aortic valve disorders

Use additional codes to specify the cause of the nonrheumatic aortic valve disorder if known (e.g., I35.0 for nonrheumatic aortic stenosis, I35.1 for nonrheumatic aortic insufficiency). If the cause is unspecified, use I35.9.

Medical necessity for treatment of nonrheumatic aortic valve disorders is established based on the severity of the condition and its impact on the patient's functional status and quality of life. Treatment may be deemed medically necessary when the benefits of intervention (e.g., symptom relief, improved cardiac function) outweigh the risks.

Diagnosis and management of non-rheumatic aortic valve disorders typically falls under the purview of cardiologists. They are responsible for diagnosing the condition, assessing its severity, determining the appropriate treatment strategy (medical management, interventional procedures, or surgery), and providing long-term follow-up care.

IMPORTANT:Excludes1: Aortic valve disorder of unspecified cause but with diseases of mitral and/or tricuspid valve(s) (I08.-), aortic valve disorder specified as congenital (Q23.0, Q23.1), aortic valve disorder specified as rheumatic (I06.-), hypertrophic subaortic stenosis (I42.1).Excludes2: Certain conditions originating in the perinatal period (P04-P96), certain infectious and parasitic diseases (A00-B99), complications of pregnancy, childbirth, and the puerperium (O00-O9A), congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99), endocrine, nutritional and metabolic diseases (E00-E88), injury, poisoning and certain other consequences of external causes (S00-T88), neoplasms (C00-D49), symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94), systemic connective tissue disorders (M30-M36), transient cerebral ischemic attacks and related syndromes (G45.-)

In simple words: Problems with the aortic valve in the heart that are not caused by rheumatic fever or a birth defect.

Nonrheumatic disorders involving the aortic valve. This includes stenosis (narrowing) and insufficiency/regurgitation (leakage), but excludes congenital and rheumatic aortic valve disorders.

Example 1: A 65-year-old patient presents with shortness of breath and chest pain. Upon examination and echocardiography, they are diagnosed with nonrheumatic aortic stenosis., A 50-year-old patient with a history of bicuspid aortic valve develops aortic regurgitation. The patient’s condition is monitored and managed medically., A 70-year-old patient with severe nonrheumatic aortic stenosis undergoes aortic valve replacement surgery.

Documentation should include the type of aortic valve disorder (stenosis, insufficiency, or mixed), the severity of the condition, the etiology (if known and non-rheumatic), associated symptoms, and any relevant diagnostic test results (e.g., echocardiogram, cardiac catheterization).

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