2025 ICD-10-CM code I34.9
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Other forms of heart disease - Other nonrheumatic mitral valve disorders Diseases of the circulatory system (I00-I99) Feed
Nonrheumatic mitral valve disorder, unspecified. This code is used when a mitral valve disorder is present but is not caused by rheumatic fever.
ICD-10 codes do not use modifiers. Modifiers are typically appended to CPT or HCPCS codes.
Medical necessity for this code is established by the presence of clinically significant symptoms or findings attributable to a nonrheumatic mitral valve disorder, as confirmed by appropriate diagnostic testing.The severity of the disorder and the need for intervention will determine the level of medical necessity.
The clinical responsibility for this code rests with the cardiologist or other physician managing the patient's cardiac condition.They are responsible for diagnosing the mitral valve disorder, determining the appropriate treatment plan, and documenting the clinical findings in detail for accurate coding and billing.
In simple words: This code describes a problem with the mitral valve in your heart that isn't caused by rheumatic fever. The mitral valve helps control blood flow in your heart.This code means there's a problem with this valve, but doctors don't have enough information to specify the exact problem.
I34.9, Nonrheumatic mitral valve disorder, unspecified, is an ICD-10-CM code used to classify instances of mitral valve dysfunction that are not attributable to rheumatic heart disease.The mitral valve is located between the left atrium and the left ventricle of the heart.This code encompasses various non-rheumatic conditions affecting the mitral valve's structure or function, including mitral regurgitation (insufficiency), mitral stenosis, mitral valve prolapse, and other unspecified disorders.Further specification of the exact nature of the disorder is not possible or not documented.
Example 1: A 65-year-old female patient presents with symptoms of shortness of breath and fatigue.Echocardiography reveals mitral regurgitation (leaking mitral valve).The cause of the regurgitation is not rheumatic in nature (e.g., degenerative valve disease), and thus I34.9 is assigned., A 40-year-old male patient undergoes a cardiac catheterization, which reveals a mildly stenotic (narrowed) mitral valve with no evidence of rheumatic heart disease.I34.9 is used to code this finding., A 72-year-old patient is admitted to the hospital with heart failure.Echocardiography shows a combination of mitral valve abnormalities, but the specific cause is unknown and not definitively rheumatic.I34.9 is assigned after evaluating all clinical information and available documentation.
** The unspecified nature of I34.9 highlights the importance of comprehensive documentation to support the diagnosis.In cases of uncertainty regarding the etiology of the mitral valve disorder, consultation with a cardiologist may be necessary to ensure accurate coding.Further investigation may be warranted to determine the underlying cause.
- Revenue Code: Revenue codes will vary depending on the specific services provided and the payer. Consult your payer's guidelines for appropriate revenue codes.
- RVU: RVUs are not directly associated with ICD-10 codes.RVUs are used in the calculation of reimbursement for procedures, which are usually coded using CPT codes.
- Global Days: Not applicable to ICD-10 codes.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Fee Schedule: Not applicable to ICD-10 codes.Fee schedules are associated with procedures and services, not diagnoses.
- Specialties:Cardiology
- Place of Service:Office, Hospital (Inpatient or Outpatient), Ambulatory Surgical Center