Medical Coding For Aortic Valve Diseases

by | Published on Dec 13, 2021 | Medical Coding

Aortic Valve Diseases
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The main function of heart valves is to make sure that the blood always flows freely in a forward direction. Also referred to as heart valve disease or valvular heart disease, aortic valve disease occurs when the aortic valve doesn’t work properly. Located between the left ventricle and the aorta, aortic valve along with pulmonic valves close to prevent backward blood flow into the heart. The disease is caused by the obstruction of the aortic valve – closes tightly or gets too tight. Cardiologists or cardiothoracic surgeons treating this disease can rely on an experienced cardiology medical coding company to get their claims submitted on time, with accurate diagnosis and procedure codes.

The aortic valve disorder may be congenital or the valve could become diseased with age (acquired). Two main types of aortic valve diseases are – Aortic Regurgitation and Aortic Stenosis. With aortic regurgitation or aortic insufficiency, the valve does not close completely and with aortic stenosis, the valve is too tight, failing to allow blood to leave the heart and spread to the body. Aortic valve stenosis is found mainly in aged men over 75, and is mainly caused by the buildup of calcium in the aortic valve. While acute aortic valve regurgitation is caused by a tear in the aortic wall or an infection of the heart, the chronic form may be caused by aging or enlargement of the aorta resulting from high blood pressure or hardening of the arteries.

Major symptoms include shortness of breath, chest pain, dizziness, fainting, fatigue, or irregular heartbeat (passing out). Narrowed or leaky valve can make the heart work even harder, which causes these symptoms. Diagnostic tests recommended may include echocardiogram, electrocardiogram, chest x-ray, blood tests, cardiac catheterization or angiogram, cardiac magnetic resonance imaging (MRI) and coronary angiography. For serious conditions, aortic valve repair or replacement surgery will be done.

ICD-10 codes to report aortic valve diseases:

  • I35.0 Nonrheumatic aortic (valve) stenosis
  • I35.1 Nonrheumatic aortic (valve) insufficiency
  • I35.2 Nonrheumatic aortic (valve) stenosis with insufficiency
  • I35.8 Other nonrheumatic aortic valve disorders
  • I35.9 Nonrheumatic aortic valve disorder, unspecified

When the aortic valve disease is documented as rheumatic, the codes are:

  • I06.0 Rheumatic aortic valve stenosis
  • I06.1 Rheumatic aortic valve insufficiency
  • I06.2 Rheumatic aortic valve stenosis with insufficiency
  • I06.8 Other rheumatic aortic valve diseases
  • I06.9 Rheumatic aortic valve disease, unspecified

To report rheumatic disease, with multiple valves diseased, use these codes –

  • I06 Rheumatic aortic valve diseases
    • I06.0 Rheumatic aortic stenosis
    • I06.1 Rheumatic aortic insufficiency
    • I06.2 Rheumatic aortic stenosis with insufficiency
    • I06.8 Other rheumatic aortic valve diseases
    • I06.9 Rheumatic aortic valve disease, unspecified
  • I07 Rheumatic tricuspid valve diseases
    • I07.0 Rheumatic tricuspid stenosis
    • I07.1 Rheumatic tricuspid insufficiency
    • I07.2 Rheumatic tricuspid stenosis and insufficiency
    • I07.8 Other rheumatic tricuspid valve diseases
    • I07.9 Rheumatic tricuspid valve disease, unspecified
  • I08 Multiple valve diseases
    • I08.0 Rheumatic disorders of both mitral and aortic valves
    • I08.1 Rheumatic disorders of both mitral and tricuspid valves
    • I08.2 Rheumatic disorders of both aortic and tricuspid valves
    • I08.3 Combined rheumatic disorders of mitral, aortic and tricuspid valves
    • I08.8 Other rheumatic multiple valve diseases
    • I08.9 Rheumatic multiple valve disease unspecified

When aortic valve disease is documented as congenital, the following codes apply:

  • Q23 Congenital malformations of aortic and mitral valves
    • Q23.0 Congenital stenosis of aortic valve
    • Q23.1 Congenital insufficiency of aortic valve
    • Q23.2 Congenital mitral stenosis
    • Q23.3 Congenital mitral insufficiency
    • Q23.4 Hypoplastic left heart syndrome
    • Q23.8 Other congenital malformations of aortic and mitral valves
    • Q23.9 Congenital malformation of aortic and mitral valves, unspecified

The most common congenital aortic valve disorder is referred to as bicuspid aortic valve and this condition occurs when the valve has only two leaflets instead of three and acquired aortic valve disease occurs because the valve simply wears out over time with age. Left untreated, this disease can result in irregular heartbeat, cardiomyopathy (thickening of the heart muscle), and heart failure. For on-time reimbursement, cardiology practices can take support from an experienced medical billing outsourcing company that stays up to date with changing reimbursement rules and billing regulations.

Natalie Tornese

Holding a CPC certification from the American Academy of Professional Coders (AAPC), Natalie is a seasoned professional actively managing medical billing, medical coding, verification, and authorization services at OSI.

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