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2025 ICD-10-CM code I34.89

This code classifies other unspecified nonrheumatic mitral valve disorders.

Always refer to the latest official ICD-10-CM coding guidelines published by the Centers for Medicare & Medicaid Services (CMS) for accurate coding practices.Pay close attention to the "Excludes1" notes associated with I34.89 to ensure appropriate code selection and avoid duplicate coding.Accurate code assignment depends heavily on specific clinical documentation.

Medical necessity for coding I34.89 is established by the presence of a nonrheumatic mitral valve disorder that requires diagnosis and management.The provider's clinical judgment, supported by appropriate documentation, confirms the need for intervention or ongoing monitoring of the patient's condition.The severity of the disorder and its impact on the patient's functionality will be relevant factors in determining medical necessity.Payer-specific policies should be consulted for more detailed criteria.

The clinical responsibility for coding I34.89 rests with the physician or qualified healthcare professional who diagnoses and manages the patient's condition.Thorough documentation of the patient's symptoms, physical examination findings, and diagnostic test results is crucial for accurate coding.The provider should clearly specify the nature of the mitral valve disorder to ensure that the most appropriate code is selected.

IMPORTANT:Related codes include I34.0 (Nonrheumatic mitral insufficiency), I34.1 (Nonrheumatic mitral prolapse), I34.2 (Nonrheumatic mitral stenosis), and I34.81 (Nonrheumatic mitral annulus calcification).The choice of code depends on the specific details of the mitral valve disorder.

In simple words: This code is used when a person has a problem with their mitral heart valve that isn't caused by rheumatic fever and doesn't fit into other specific categories of mitral valve disorders.The mitral valve is one of the heart's four valves, and this code indicates that it's not working correctly.

I34.89, Other nonrheumatic mitral valve disorders, encompasses any nonrheumatic mitral valve condition not otherwise specified by codes I34.0 (Nonrheumatic mitral insufficiency), I34.1 (Nonrheumatic mitral prolapse), I34.2 (Nonrheumatic mitral stenosis), or I34.81 (Nonrheumatic mitral annulus calcification).It includes various structural or functional abnormalities of the mitral valve that are not caused by rheumatic fever.The condition may involve the leaflets, chordae tendineae, papillary muscles, or annulus.Specific details regarding the nature of the disorder should be documented.

Example 1: A 65-year-old patient presents with shortness of breath and fatigue.Echocardiography reveals mild mitral regurgitation without evidence of rheumatic heart disease or other specified nonrheumatic causes.The physician documents the mitral valve dysfunction without further specifying a sub-type., A 40-year-old patient undergoes a cardiac catheterization that reveals a structural abnormality of the mitral valve leaflets.The echocardiogram shows a minimally significant degree of mitral regurgitation, but there is no evidence of prolapse, stenosis, or calcification.The abnormality is not a consequence of rheumatic heart disease., A 70-year-old patient with a history of hypertension presents with worsening heart failure.Transthoracic echocardiography shows a moderately severe degree of mitral regurgitation with no evidence of rheumatic heart disease or other clarified forms of nonrheumatic mitral valve disease.The provider documents this finding without specifying the underlying cause of the regurgitation.

Complete and detailed documentation is crucial.This includes:* Patient's history and symptoms.* Physical examination findings.* Results of diagnostic tests such as echocardiography, cardiac catheterization, and any relevant imaging studies.* Provider's assessment and diagnosis, clearly specifying the nature of the mitral valve disorder and its severity.* Documentation should exclude rheumatic heart disease, congenital causes, and other specified nonrheumatic mitral valve disorders.

** I34.89 is a residual code used when the specific type of nonrheumatic mitral valve disorder cannot be determined from the available clinical information.It is essential to document the reason for assigning this code to prevent improper use.

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