2025 ICD-10-CM code I37.2
(Active) Effective Date: N/A Revision Date: N/A Other forms of heart disease - Nonrheumatic pulmonary valve disorders Diseases of the circulatory system (I00-I99) Feed
Nonrheumatic pulmonary valve stenosis with insufficiency.
Modifiers may be applicable depending on the circumstances of service and procedures performed.
Medical necessity for diagnosis and treatment of I37.2 is determined by the presence of symptoms (e.g., shortness of breath, chest pain, syncope) and the severity of the valve disorder as assessed by imaging studies.The treatment choice (medical management vs. intervention) is guided by the severity of symptoms and the impact on heart function.
The clinical responsibility for I37.2 lies with cardiologists and cardiac surgeons.They are responsible for diagnosis through clinical examination, echocardiography, cardiac catheterization, and other imaging techniques.Management may involve medication, interventions such as balloon valvuloplasty or valve replacement surgery, and ongoing monitoring.
In simple words: This code describes a heart problem where the valve between the heart and the lungs is both narrow and leaky, causing the heart to work harder.This isn't caused by rheumatic fever.
I37.2, Nonrheumatic pulmonary valve stenosis with insufficiency, refers to a heart condition where the pulmonary valve, which controls blood flow from the heart to the lungs, is narrowed (stenosis) and doesn't close properly (insufficiency or regurgitation). This is not caused by rheumatic fever.The stenosis restricts blood flow, while the insufficiency allows backflow of blood, potentially leading to heart strain and other complications.
Example 1: A 60-year-old patient presents with shortness of breath and chest pain.Echocardiography reveals nonrheumatic pulmonary valve stenosis with mild insufficiency.The physician manages the patient medically with diuretics and ACE inhibitors., A 3-month-old infant is diagnosed with nonrheumatic pulmonary valve stenosis with significant insufficiency resulting in cyanosis and heart failure.The infant undergoes cardiac catheterization and pulmonary valvuloplasty., A 45-year-old patient with a history of pulmonary hypertension is found to have moderate nonrheumatic pulmonary valve stenosis and insufficiency during a routine checkup.They are referred to a cardiac surgeon who determines that valve replacement surgery is necessary.
Comprehensive medical history, physical examination findings, echocardiogram reports (including valve area calculation, regurgitation grade), cardiac catheterization data (if performed), imaging reports (if performed), lab results, and treatment plan.
** Always refer to the most current ICD-10-CM coding guidelines for the most up-to-date information and coding conventions.This information is current as of December 3, 2024.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Cardiology, Cardiac Surgery
- Place of Service:Office, Hospital (Inpatient and Outpatient), Ambulatory Surgical Center