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2025 ICD-10-CM code I06.1

Rheumatic aortic insufficiency.

Code I06.1 should be used when the documentation specifically confirms that aortic insufficiency is a consequence of rheumatic fever. If other causes are present, or the connection to rheumatic fever isn't clearly established, alternative codes may be appropriate.Always prioritize clear documentation and adhere to current ICD-10-CM coding guidelines.

The medical necessity for treatments related to rheumatic aortic insufficiency stems from the detrimental effects of blood flowing backward in the heart. This can lead to progressive heart failure and reduced quality of life. Establishing medical necessity for interventions like valve replacement necessitates thorough documentation of the severity of the insufficiency and its impact on the patient's cardiac function.

Diagnosis and management of patients with rheumatic heart disease.

In simple words: This condition occurs when the heart's aortic valve, previously damaged by rheumatic fever, doesn't close properly, causing blood to flow backward within the heart.

Rheumatic aortic insufficiency, also known as rheumatic aortic incompetence or rheumatic aortic regurgitation, is a condition where the aortic valve, damaged by rheumatic fever, doesn't close completely, causing blood to leak back into the left ventricle.

Example 1: A 55-year-old patient presents with shortness of breath, fatigue, and a heart murmur. Echocardiography reveals aortic insufficiency. History indicates previous rheumatic fever, thus confirming I06.1., A patient with a known history of rheumatic fever is admitted to the hospital for heart failure. The diagnosis of rheumatic aortic insufficiency is confirmed through imaging and clinical exam., During a routine cardiac checkup for a 70-year-old with a history of rheumatic fever, tests uncover aortic insufficiency. The documentation explicitly links the insufficiency to past rheumatic fever, justifying the use of I06.1.

Documentation should confirm the presence of aortic insufficiency and link it directly to a history of rheumatic fever. Echocardiography results detailing the valve abnormality, alongside a clear patient history, are typically required for accurate reporting.

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