2025 ICD-10-CM code I07
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Diseases of the circulatory system - Chronic rheumatic heart diseases Diseases of the circulatory system (I00-I99) Feed
Rheumatic tricuspid valve diseases.
Modifiers may be applicable depending on the specific circumstances of the encounter (e.g., place of service, type of service). Consult the appropriate payer guidelines for modifier usage.
The medical necessity for coding I07 is established by the presence of symptoms and signs consistent with rheumatic heart disease, confirmed by appropriate diagnostic testing, demonstrating the impact on cardiac function, and necessitating medical or surgical intervention.
Cardiologist, Cardiac surgeon
In simple words: This code describes problems with the tricuspid heart valve caused by rheumatic fever.The tricuspid valve is one of the four valves in the heart.This code covers different types of valve problems, like stenosis (narrowing) or insufficiency (leaking).
This code encompasses rheumatic diseases affecting the tricuspid valve, including stenosis, insufficiency, or combined stenosis and insufficiency.It includes cases specified as rheumatic or of unspecified origin.It excludes tricuspid valve disease specified as nonrheumatic (I36.-) and tricuspid valve disease with aortic and/or mitral valve involvement (I08.-).
Example 1: A 55-year-old patient presents with symptoms of heart failure, including shortness of breath and edema.Echocardiography reveals rheumatic tricuspid valve insufficiency. The physician documents the diagnosis as I07.1., A 60-year-old patient with a history of rheumatic fever undergoes cardiac catheterization, which demonstrates significant rheumatic tricuspid stenosis (I07.0). The procedure report describes the severity of the stenosis and the impact on cardiac function., A 70-year-old patient is admitted with worsening symptoms of heart failure.Echocardiogram demonstrates significant rheumatic tricuspid stenosis with insufficiency (I07.2).The physician orders medication and discusses further management options.
Detailed patient history including history of rheumatic fever, physical examination findings, echocardiogram report, cardiac catheterization reports (if performed), and other relevant diagnostic tests.
** This code is for rheumatic involvement of the tricuspid valve.Always use the most specific code possible based on the available clinical documentation. If multiple valve diseases are present, code each separately, using the appropriate combination codes where available (I08).
- Payment Status: Active
- Specialties:Cardiology, Cardiovascular Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office