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2025 ICD-10-CM code T82.01XA

Breakdown (mechanical) of heart valve prosthesis, initial encounter.

Use secondary codes from Chapter 20, External causes of morbidity (V00-Y99), to indicate the cause of the injury, if applicable. Use an additional code to identify any retained foreign body, if applicable (Z18.-).

Medical necessity for using this code relies on the clear documentation of a mechanical breakdown of the heart valve prosthesis. The symptoms and diagnostic findings must support the diagnosis, and the treatment provided must be appropriate for the condition.

It is the clinical responsibility of the healthcare provider to diagnose the mechanical breakdown, assess the patient's condition, and determine the appropriate course of treatment, which may include medication, surgical intervention, or other therapies.

In simple words: This code indicates a mechanical failure of an artificial heart valve during the first visit when the problem occurred.

This code describes a mechanical breakdown of a heart valve prosthesis during the initial encounter.

Example 1: A patient presents with shortness of breath and chest pain after a recent heart valve replacement surgery. Diagnostic imaging reveals a fractured component within the prosthetic valve, necessitating further intervention., During a routine follow-up appointment, a patient with a heart valve replacement experiences palpitations. An echocardiogram shows a displacement of the prosthetic valve, leading to a diagnosis of mechanical breakdown., A patient with a history of heart valve replacement reports fatigue and dizziness. After thorough examination, including cardiac imaging, the physician determines that the prosthetic valve is leaking, requiring surgical repair.

Documentation should include details of the patient's symptoms, diagnostic findings (e.g., imaging studies, physical exam), and the physician's assessment of the mechanical breakdown. The type and location of the heart valve prosthesis should be specified.

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