2025 ICD-10-CM code I37.8
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Other forms of heart disease - Other nonrheumatic pulmonary valve disorders Diseases of the circulatory system Feed
This code represents other nonrheumatic disorders affecting the pulmonary valve, excluding those specified as congenital or rheumatic.
Modifiers are not applicable to ICD-10 codes.
Medical necessity for coding I37.8 would be established by clinical evidence of a pulmonary valve disorder.Documentation supporting the diagnosis and clinical significance of the disorder needs to be provided, justifying any treatment or intervention undertaken.
The clinical responsibility involves diagnosing and managing the patient's condition.This may include obtaining a thorough history, performing a physical exam, ordering and interpreting diagnostic tests (such as echocardiograms, cardiac catheterization), and developing a treatment plan that may involve medication, surgery, or other interventions to manage the pulmonary valve disorder.
In simple words: This code describes problems with the pulmonary valve in the heart that aren't caused by rheumatic fever or present from birth.The problem might be with how the valve works or its structure.A doctor will need to explain the specific issue.
I37.8, Other nonrheumatic pulmonary valve disorders, encompasses various conditions affecting the pulmonary valve's structure and function that are not caused by rheumatic fever and are not classified as congenital.These may include, but are not limited to,non-rheumatic pulmonary valve dysfunction not otherwise specified,specific valve abnormalities not falling under other I37 codes, and other non-rheumatic valvular disorders not elsewhere classified. The diagnosis requires detailed documentation specifying the nature of the disorder, its temporal aspects, the affected valve, the cause, and any related clinical findings.
Example 1: A 60-year-old patient presents with shortness of breath and chest pain.Echocardiography reveals non-rheumatic pulmonary valve insufficiency.I37.8 is used to code the diagnosis., A 45-year-old patient undergoes cardiac catheterization revealing mild non-rheumatic pulmonary valve stenosis with no other significant findings, not meeting the criteria for I37.0 or I37.2.I37.8 is the appropriate code., A 72-year-old patient with a history of hypertension is diagnosed with a non-rheumatic functional pulmonary valve disorder of unknown etiology after a comprehensive evaluation. This is coded as I37.8 due to the absence of stenosis or insufficiency.
Detailed clinical documentation is crucial and should include the patient's history, physical examination findings, results of diagnostic tests (e.g., echocardiogram, cardiac catheterization), and justification for the diagnosis of a non-rheumatic pulmonary valve disorder.
** Always ensure proper documentation supports the selection of I37.8, as insufficient information might lead to the use of unspecified codes.Accurate coding relies on clear clinical information describing the nature and cause of the pulmonary valve disorder.Differentiate from congenital (Q22 codes) and rheumatic (I09 codes) conditions.
- Revenue Code: Revenue codes will vary depending on the specific services provided and the payer's coding guidelines.
- RVU: RVUs are not applicable to ICD-10 codes. RVUs are associated with CPT codes, which describe procedures and services. Reimbursement for diagnoses (ICD-10 codes) is determined by the specific services provided and the payer's policies.
- 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.
- Specialties:Cardiology
- Place of Service:Office, Hospital (Inpatient or Outpatient), Ambulatory Surgical Center