2025 ICD-10-CM code T82.03XA
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Injury - Complications of surgical and medical care, not elsewhere classified (T80-T88) Chapter 19: Injury, poisoning and certain other consequences of external causes (S00-T88) Feed
Leakage of a heart valve prosthesis, initial encounter.
Not applicable to ICD-10 codes. Modifiers are used with CPT and HCPCS codes.
The medical necessity of this code hinges on the clinical presentation of the patient. This would include symptoms suggestive of heart valve dysfunction (e.g., shortness of breath, chest pain, fatigue) and echocardiographic evidence of paravalvular leakage significant enough to warrant intervention.The severity and impact on the patient's health determine medical necessity.
The clinical responsibility depends on the setting.In the hospital, it would involve the cardiothoracic surgeon, cardiologist, and other relevant medical professionals. In an outpatient setting, the cardiologist and possibly a cardiac surgeon might be involved.
- Chapter 19: Injury, poisoning and certain other consequences of external causes (S00-T88)
- T82.0-T82.9: Mechanical complications of cardiac devices
In simple words: This code describes a problem with a heart valve replacement. Specifically, it means there is a leak in the new heart valve, and this is the first time this problem has been recorded.More information may be needed to fully describe the situation.
This code classifies the initial encounter for leakage of a prosthetic heart valve.It is used to report complications arising from the malfunction of an implanted heart valve prosthesis, specifically when leakage is the primary issue.This code should be used in conjunction with additional codes to specify the type of valve, location of the leakage, and any associated procedures or complications.
Example 1: A 70-year-old patient with a history of aortic stenosis undergoes an aortic valve replacement.Postoperatively, echocardiography reveals paravalvular leakage.The code T82.03XA is assigned to represent this complication., A 65-year-old patient with a history of mitral valve regurgitation has a mitral valve replacement. Three months post-surgery, the patient experiences symptoms of heart failure.Echocardiography shows mild paravalvular leakage. T82.03XA is assigned, and additional codes may be used to document heart failure., A 80-year-old patient has a mechanical mitral valve replacement. During a routine follow-up echocardiogram six months later, significant paravalvular leakage is detected. T82.03XA is used in addition to codes describing the extent of leakage and the patient's clinical status.
Detailed echocardiogram reports showing the presence and severity of the leakage.Preoperative and postoperative notes, including details of the surgical procedure, valve type, and any relevant intraoperative events.Hospital records documenting the patient's clinical course.
** This code specifically applies to the initial encounter for the leakage. Subsequent encounters should utilize the appropriate 7th character to indicate the encounter status (e.g., A for initial encounter, D for subsequent encounter).
- Revenue Code: Revenue codes will vary depending on the payer and the specific services provided. Consult your payer's guidelines for appropriate revenue codes.
- RVU: RVUs are not directly assigned to ICD-10 codes.Reimbursement is based on the procedures performed and the services rendered in conjunction with the diagnosis.The RVU value varies depending on the location of service, type of practice (e.g., physician, hospital), and payment system (e.g., Medicare, private payer).
- Global Days: Not applicable to ICD-10 codes. Global surgical days are associated with CPT codes.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Fee Schedule: Not applicable to ICD-10 codes. Fee schedules relate to procedures and services, not diagnoses.
- Specialties:Cardiology, Cardiothoracic Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center