2025 ICD-10-CM code Q22.2
Congenital pulmonary valve insufficiency (also known as congenital pulmonary valve regurgitation). This is a condition present from birth where the pulmonary valve doesn't close properly, allowing blood to flow back into the right ventricle.
Medical necessity for interventions related to Q22.2 is established by documenting the severity of the valve insufficiency and its impact on the patient's cardiac function and overall health. This may include evidence of symptoms such as shortness of breath, fatigue, or exercise intolerance, as well as objective findings like reduced ejection fraction or pulmonary hypertension. The documentation should justify the need for any procedures, medications, or other treatments.
Diagnosing and managing congenital pulmonary valve insufficiency typically falls under the purview of pediatric cardiologists or congenital heart specialists. They are responsible for evaluating the severity of the condition, monitoring its progression, and determining the appropriate course of treatment.
In simple words: The pulmonary valve is a one-way door in your heart that lets blood flow from the heart to the lungs. With congenital pulmonary valve insufficiency, this valve is leaky from birth. This means some blood flows backward, making the heart work harder.
Congenital pulmonary valve insufficiency is a birth defect affecting the pulmonary valve, which is located between the right ventricle and the pulmonary artery.In a normal heart, the pulmonary valve closes tightly after the right ventricle pumps blood into the pulmonary artery, preventing blood from flowing back into the ventricle. In pulmonary valve insufficiency, the valve doesn't close completely, causing blood to leak back into the right ventricle. This can make the heart work harder and potentially lead to various symptoms like shortness of breath, weakness, and fatigue.
Example 1: A newborn infant presents with cyanosis and a heart murmur.Echocardiography reveals congenital pulmonary valve insufficiency with a ventricular septal defect., A 4-year-old child experiences frequent respiratory infections and shortness of breath during physical activity. Diagnostic tests confirm congenital pulmonary valve insufficiency as an isolated cardiac malformation., A teenager with a history of congenital heart disease is found to have progressive pulmonary valve insufficiency, requiring surgical intervention.
Thorough documentation is essential for accurate coding of Q22.2. This includes a detailed clinical history, physical examination findings, and results of diagnostic tests such as echocardiography, cardiac catheterization, and electrocardiography (ECG). The documentation should clearly describe the insufficiency's severity, associated symptoms, and any related conditions.
** Congenital pulmonary valve insufficiency is not to be used on maternal records. It is excluded from inborn errors of metabolism.
- Specialties:Pediatric cardiology, Congenital heart surgery
- Place of Service:Inpatient Hospital, On Campus-Outpatient Hospital, Office