394.x-398.x and 424.x: Clarify the Role of ‘Rheumatic’

Use this cheat sheet to aid your non-congenital valve disorder coding

 

Code Descriptor Role of ‘Rheumatic’

 

MITRAL VALVE ONLY

 

394.0 Mitral stenosis Use if specified as rheumatic or unspecified. If specified as non-rheumatic, use 424.0.
394.1 Rheumatic mitral insufficiency Specific to rheumatic cases. For others, use 424.0.
394.2 Mitral stenosis with insufficiency Use if specified as rheumatic or unspecified. If specified as non-rheumatic, use 424.0.
394.9 Other and unspecified mitral valve disease Use if specified as rheumatic or unspecified. If specified as non-rheumatic, use 424.0.
424.0 Mitral valve disorders Use if specified as non-rheumatic. Also use for mitral insufficiency of unspecified cause.
AORTIC VALVE ONLY
395.0 Rheumatic aortic stenosis Specific to rheumatic cases. For others, use 424.1.
395.1 Rheumatic aortic insufficiency Specific to rheumatic cases. For others, use 424.1.
395.2 Rheumatic aortic stenosis with insufficiency Specific to rheumatic cases. For others, use 424.1.
395.9 Other and unspecified rheumatic aortic diseases Specific to rheumatic cases. For others, use 424.1.
424.1 Aortic valve disorders Use if specified as non-rheumatic or unspecified. If specified as rheumatic, see 395.x.
BOTH MITRAL AND AORTIC VALVES

 

396.0 Mitral valve

...

Use this cheat sheet to aid your non-congenital valve disorder coding

 

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Code Descriptor Role of ‘Rheumatic’

 

MITRAL VALVE ONLY

 

394.0 Mitral stenosis Use if specified as rheumatic or unspecified. If specified as non-rheumatic, use 424.0.
394.1 Rheumatic mitral insufficiency Specific to rheumatic cases. For others, use 424.0.
394.2 Mitral stenosis with insufficiency Use if specified as rheumatic or unspecified. If specified as non-rheumatic, use 424.0.
394.9 Other and unspecified mitral valve disease Use if specified as rheumatic or unspecified. If specified as non-rheumatic, use 424.0.
424.0 Mitral valve disorders Use if specified as non-rheumatic. Also use for mitral insufficiency of unspecified cause.
AORTIC VALVE ONLY
395.0 Rheumatic aortic stenosis Specific to rheumatic cases. For others, use 424.1.
395.1 Rheumatic aortic insufficiency Specific to rheumatic cases. For others, use 424.1.
395.2 Rheumatic aortic stenosis with insufficiency Specific to rheumatic cases. For others, use 424.1.
395.9 Other and unspecified rheumatic aortic diseases Specific to rheumatic cases. For others, use 424.1.
424.1 Aortic valve disorders Use if specified as non-rheumatic or unspecified. If specified as rheumatic, see 395.x.
BOTH MITRAL AND AORTIC VALVES

 

396.0 Mitral valve stenosis and aortic valve stenosis Use whether specified as rheumatic or not.
396.1 Mitral valve stenosis and aortic valve insufficiency Use whether specified as rheumatic or not.
396.2 Mitral valve insufficiency and aortic valve stenosis Use whether specified as rheumatic or not.
396.3 Mitral valve insufficiency and aortic valve

insufficiency

Use whether specified as rheumatic or not.
396.8 Multiple involvement of mitral and aortic valves Use whether specified as rheumatic or not.
396.9 Mitral and aortic valve diseases, unspecified Use whether specified as rheumatic or not.
PULMONARY, TRICUSPID, OR UNSPECIFIED VALVE

 

397.0 Diseases of tricuspid valve Use if specified as rheumatic or unspecified. If specified as non-rheumatic, use 424.2.
397.1 Rheumatic diseases of pulmonary valve Specific to rheumatic cases. For others, use 424.3.
397.9 Rheumatic diseases of endocardium, valve

unspecified

Specific to rheumatic cases. For others, use 424.9x.
424.2 Tricuspid valve disorders, specified as

Non-rheumatic

Specific to non-rheumatic cases. If specified as rheumatic or unspecified, use 397.0.
424.3 Pulmonary valve disorders Use if specified as non-rheumatic or unspecified. If cause is specified as rheumatic, use 397.1.
424.90 Endocarditis, valve unspecified, unspecified cause Use when both valve and cause are unspecified.

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