2025 ICD-10-CM code I05.0
Rheumatic mitral stenosis. Narrowing of the mitral valve opening.
Medical necessity for services related to I05.0 rests on the presence of signs and symptoms, functional limitations, and the severity of the mitral stenosis.Interventions, whether medical or surgical, must be justified based on the patient's clinical presentation and the potential benefits of treatment.
Diagnosis and management of this condition fall under the purview of cardiology.Cardiologists are responsible for assessing the severity of the stenosis, managing symptoms, and determining the need for interventions like medication or surgery. This may involve diagnostic tests such as echocardiograms, electrocardiograms (ECGs), and cardiac catheterization.
In simple words: Rheumatic mitral stenosis is a heart valve problem where the valve between the top left and bottom left chambers of the heart becomes narrowed. This narrowing is caused by scarring and hardening of the valve. It makes it harder for blood to flow through the heart, which can lead to shortness of breath and a rapid heartbeat, especially during activity.
Rheumatic mitral stenosis is a condition characterized by the narrowing of the mitral valve orifice, the opening between the left atrium and left ventricle of the heart. This narrowing is typically due to fibrosis (scarring) and calcification of the valve leaflets and chordae tendineae, the fibrous cords that support the valve.The restricted blood flow leads to increased pressure in the left atrium, which backs up into the pulmonary veins and capillaries, potentially causing symptoms like shortness of breath (dyspnea) and rapid heart rate (tachycardia), particularly during physical exertion.Rheumatic fever is the primary cause of this condition.
Example 1: A 55-year-old patient presents with increasing shortness of breath and fatigue, particularly on exertion. They have a history of rheumatic fever in childhood.An echocardiogram reveals mitral valve stenosis, and the patient is diagnosed with I05.0., A patient with a known history of rheumatic heart disease (I09.9) is found to have a new murmur on physical exam. Further investigation with an echocardiogram confirms mitral stenosis, leading to the additional diagnosis of I05.0., A patient experiencing atrial fibrillation is admitted to the hospital. During workup, echocardiography shows significant mitral stenosis contributing to the irregular heart rhythm.The patient receives both the I05.0 and the code for atrial fibrillation.
Documentation should include details of the diagnostic tests confirming the presence and severity of the stenosis (e.g., echocardiogram findings, cardiac catheterization results).The patient's symptoms, such as shortness of breath, chest pain, or palpitations, should be documented, along with their severity and any functional limitations. A history of rheumatic fever, if present, is crucial, as is documentation of any other cardiac conditions.
- Payment Status: Active
- Specialties:Cardiology
- Place of Service:Inpatient Hospital, On Campus-Outpatient Hospital, Off Campus-Outpatient Hospital, Office, Independent Clinic