2025 ICD-10-CM code I07.9
(Active) Effective Date: N/A Chronic rheumatic heart diseases - Rheumatic tricuspid valve diseases Diseases of the circulatory system (I00-I99) Feed
Rheumatic tricuspid valve disease, unspecified.
Medical necessity is established by the diagnosis of rheumatic tricuspid valve disease. The need for any specific treatment or intervention would depend on the severity of the valve dysfunction and the patient's overall clinical picture.
The physician is responsible for documenting the diagnosis of rheumatic tricuspid valve disease and specifying the type of dysfunction if known. If the specific dysfunction is not documented, I07.9 is the appropriate code.
In simple words: This code indicates a problem with the heart's tricuspid valve caused by rheumatic fever, but the specifics of the problem are not known.
Rheumatic tricuspid valve disease, unspecified. This code is used when the tricuspid valve is affected by rheumatic heart disease, but the specific type of dysfunction (stenosis, insufficiency, or combined) is not documented.
Example 1: A patient with a history of rheumatic fever presents with symptoms of heart failure. Echocardiography reveals tricuspid valve dysfunction, but the physician does not specify whether it is stenosis, insufficiency, or a combination. I07.9 is used., A patient with known rheumatic heart disease is admitted for a non-cardiac procedure. The medical record mentions tricuspid valve disease without further details. I07.9 is appropriate., A patient is being evaluated for shortness of breath. An echocardiogram shows mild tricuspid regurgitation, but there is no clear documentation of rheumatic fever history or other cause. I07.9 would not be used; further investigation and documentation are needed.
Documentation should include evidence of rheumatic fever or rheumatic heart disease, as well as any signs or symptoms related to the tricuspid valve. Ideally, the specific type of valve dysfunction should be documented (stenosis, insufficiency, or combined). If this is not possible, then the unspecified code I07.9 can be used.
- Specialties:Cardiology
- Place of Service:Inpatient Hospital, On Campus-Outpatient Hospital, Office