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2025 ICD-10-CM code Q23.3

Congenital mitral insufficiency. This is a birth defect affecting the mitral valve of the heart, which prevents it from closing properly.

Use this code to report congenital mitral insufficiency as a primary or secondary diagnosis. Do not use this code for maternal records.Refer to ICD-10-CM guidelines for proper coding and reporting.

Medical necessity for treatment of congenital mitral insufficiency is established by the presence of symptoms, evidence of cardiac dysfunction, or progression of the condition.The severity of the insufficiency and the potential risks and benefits of intervention must be carefully considered.

Diagnosis and management of this condition are typically handled by pediatric cardiologists. They will assess the severity of the insufficiency and determine the appropriate course of treatment, which may range from medication to surgical intervention.

In simple words: A baby is born with a leaky heart valve called the mitral valve. This valve is supposed to close tightly to keep blood flowing in the right direction, but with this condition, it doesn't close all the way.This makes the heart work harder and can cause problems like shortness of breath.

Congenital mitral insufficiency is a condition present at birth where the mitral valve, located between the left atrium and left ventricle of the heart, does not close completely. This allows blood to flow back into the left atrium when the left ventricle contracts, making the heart work harder and potentially leading to symptoms like shortness of breath and heart palpitations. The severity of symptoms depends on the amount of blood leaking back through the valve.

Example 1: A newborn infant is diagnosed with a heart murmur during a routine checkup. Further investigation with an echocardiogram reveals congenital mitral insufficiency., A child experiences shortness of breath and fatigue during physical activity. Diagnostic tests show congenital mitral insufficiency as the underlying cause., A teenager with a history of congenital mitral insufficiency develops heart palpitations. This necessitates a reevaluation of the condition and adjustment of the treatment plan.

Thorough documentation should include the diagnostic findings from echocardiograms, cardiac catheterizations, and other relevant tests.Physician notes should describe the severity of the insufficiency, associated symptoms, and treatment plan.

** Congenital mitral insufficiency may be associated with other congenital heart defects. Careful evaluation is needed to identify any coexisting conditions.

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