2025 ICD-10-CM code T82.09XA
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Injury - Other mechanical complications of heart valve prosthesis Chapter 19: Injury, poisoning and certain other consequences of external causes Feed
Other mechanical complication of a heart valve prosthesis, initial encounter.
Modifiers may be applicable depending on the circumstances of the encounter and the specific services provided. Consult the appropriate modifier guidelines for further information.
Medical necessity for coding T82.09XA is established by the presence of a documented mechanical complication of a heart valve prosthesis, requiring medical intervention. This includes, but is not limited to, symptoms indicative of valve dysfunction (e.g., shortness of breath, chest pain, murmur), objective findings on imaging, and appropriate treatment or surgical intervention based on the clinical presentation.
The clinical responsibility includes diagnosing the mechanical complication of the heart valve prosthesis, determining the nature of the malfunction (e.g., fracture, dislocation, obstruction),managing the patient's condition, and documenting the findings accurately for coding purposes.Surgical intervention, replacement of the prosthesis, or other therapeutic interventions might be necessary depending on the severity of the complication.
- Chapter 19: Injury, poisoning and certain other consequences of external causes
- T82.0-T82.2: Complications of cardiac and vascular devices and implants
In simple words: This code is used when there's a problem with an artificial heart valve that isn't listed separately.It is used for the first time this problem is seen by a doctor. The doctor needs to provide specific details about what exactly went wrong with the valve.
This code classifies the initial encounter for any mechanical complication of a heart valve prosthesis that is not specifically defined by other codes within the T82.0-T82.2 series.It encompasses a range of malfunctions not otherwise specified, requiring further clinical detail for accurate coding and reimbursement.Use of this code necessitates complete and precise documentation of the specific mechanical issue encountered with the prosthesis.
Example 1: A patient presents with sudden onset of shortness of breath and chest pain following a previous heart valve replacement.Echocardiography reveals a fractured valve leaflet.T82.09XA is used to code the initial encounter for this mechanical complication., A post-operative patient experiences worsening heart failure symptoms. Examination and imaging studies identify a displaced prosthetic heart valve.T82.09XA is utilized, along with appropriate codes to indicate the cause and subsequent management of the complication., A patient with a history of prosthetic heart valve implantation develops a new heart murmur. Diagnostic studies confirm a partial obstruction of the prosthetic valve due to thrombus formation. This scenario requires T82.09XA, with additional codes reflecting the specific complications and associated treatment.
Thorough documentation is required, including the type of heart valve prosthesis, date of implantation, complete history of the present illness detailing the onset and nature of symptoms, findings from diagnostic studies (e.g., echocardiogram, cardiac catheterization), detailed description of the mechanical complication,and a complete record of the treatment provided.
** This code is for the initial encounter only. Subsequent encounters for the same complication should use the appropriate seventh character for subsequent encounters.Always refer to the most current version of the ICD-10-CM coding manual for the most up-to-date guidelines and clarifications.Accurate coding requires comprehensive clinical documentation.
- Payment Status: Active
- Specialties:Cardiology, Cardiovascular Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center