Mitral Regurgitation ICD-10-CM Codes

Learn about the specific codes for mitral regurgitation, clinical descriptions, and billing implications.

By Gale Alagos on Apr 15, 2025.

Fact Checked by Karina Jimenea.

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Mitral Regurgitation ICD-10-CM Codes

What ICD-10 codes are used for mitral regurgitation?

Mitral regurgitation is when the mitral valve in the heart doesn't close tightly, allowing blood to flow backward into the heart. Here are the commonly used Mitral Regurgitation ICD-10 CM codes:

  • I05.1: Rheumatic mitral insufficiency
  • I34.0: Nonrheumatic mitral (valve) insufficiency
  • I34.1: Nonrheumatic mitral (valve) prolapse
  • I34.2: Nonrheumatic mitral (valve) stenosis
  • I34.8: Other nonrheumatic mitral valve disorders
  • I34.9: Nonrheumatic mitral valve disorder, unspecified

Clinical information

Mitral regurgitation is a complex condition involving blood backflow through the mitral valve. It can have various underlying causes, requiring careful documentation for accurate coding.

  • Mitral regurgitation occurs when the mitral valve fails to close properly, allowing blood to flow backward from the left ventricle to the left atrium during systole. In some patients, this condition may affect both the mitral and aortic valves simultaneously, complicating diagnosis and treatment approaches.
  • Primary causes include degenerative valve disease, mitral valve annular calcification, myxomatous degeneration, and papillary muscle dysfunction. Secondary causes include left ventricular dilation, ischemic heart disease, and various forms of cardiomyopathy.
  • Rheumatic aortic valve disease may accompany mitral valve dysfunction, particularly in patients with a history of rheumatic fever. Some patients present with combined stenosis with insufficiency, requiring careful differentiation in coding and treatment planning.
  • Symptoms typically include shortness of breath (dyspnea), fatigue, palpitations, and exercise intolerance that worsen as the condition progresses. In some cases, the tricuspid valve may be involved, resulting in right-sided heart symptoms and requiring additional coding considerations.
  • Advanced imaging is essential for diagnosis, with echocardiography being the gold standard for visualizing mitral valve annulus calcification and quantifying regurgitation severity. Cardiac MRI and cardiac catheterization may be necessary for comprehensive evaluation, particularly when assessing for concomitant valve diseases.
  • Treatment options range from medication management (diuretics, beta-blockers, ACE inhibitors) to surgical interventions, including valve repair or replacement.
  • Rheumatic aortic stenosis may coexist with mitral regurgitation, especially in patients with a history of rheumatic heart disease, requiring documentation of both conditions.
  • When coding, it's essential to specify whether the condition is rheumatic or non-rheumatic, as this affects ICD-10-CM code selection.
  • For patients with unspecified valve disease, additional testing should be pursued to determine the specific valve pathology for accurate coding. Early diagnosis and appropriate treatment are crucial to prevent complications such as atrial fibrillation, pulmonary hypertension, and heart failure.

Clinical Information

Mitral regurgitation can have various underlying causes and may require medical intervention. Here's what you need to know:

  • Symptoms may include shortness of breath, fatigue, and palpitations.
  • The condition can be caused by mitral valve prolapse, rheumatic heart disease, or coronary artery disease.
  • Diagnosis involves echocardiography, cardiac MRI, and sometimes cardiac catheterization.
  • Treatment options include medications like diuretics and beta-blockers and surgical interventions like valve repair or replacement.
  • Early diagnosis and treatment are crucial to prevent complications like heart failure.

Synonyms include:

  • Mitral insufficiency
  • Rheumatic mitral regurgitation
  • Mitral valve leakage
  • Backflow of blood in the mitral valve
  • Mitral valve disorder
  • Heart valve regurgitation

Commonly asked questions

What are the common symptoms of mitral regurgitation?

Common symptoms of mitral regurgitation include shortness of breath (dyspnea), especially during exertion or when lying down, palpitations, fatigue, and swelling in the feet or ankles. In severe cases, symptoms can develop suddenly and may resemble those of acute heart failure, such as rapid breathing and decreased exercise tolerance. Mild cases may be asymptomatic for years until the condition progresses.

How is mitral regurgitation diagnosed?

Mitral regurgitation is diagnosed primarily through a combination of physical examination and echocardiography. The physical exam may reveal a holosystolic murmur at the apex, while echocardiography, particularly transthoracic echo with color Doppler flow, is used to confirm the presence, severity, and mechanism of the regurgitation.

What are the treatment options for mitral regurgitation?

Treatment options for mitral regurgitation depend on the severity and symptoms. Mild cases may be monitored with regular check-ups. For more severe or symptomatic cases, surgical interventions such as mitral valve repair or replacement are often necessary. Transcatheter mitral valve repair is also an option for some patients, offering a less invasive alternative to traditional surgery. The choice of treatment is tailored to each patient's condition and overall health status.

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