2022 ICD-10-CM Code I36.1
Nonrheumatic tricuspid (valve) insufficiency
Valid for Submission
| ICD-10: | I36.1 |
| Short Description: | Nonrheumatic tricuspid (valve) insufficiency |
| Long Description: | Nonrheumatic tricuspid (valve) insufficiency |
Code Classification
I36.1 is a billable diagnosis code used to specify a medical diagnosis of nonrheumatic tricuspid (valve) insufficiency. The code I36.1 is valid during the fiscal year 2022 from October 01, 2021 through September 30, 2022 for the submission of HIPAA-covered transactions.
The ICD-10-CM code I36.1 might also be used to specify conditions or terms like acute prosthetic tricuspid valve regurgitation, disorder of tricuspid valve prosthesis, functional tricuspid regurgitation, postprocedural regurgitation of tricuspid valve, prosthetic tricuspid valve regurgitation , tricuspid incompetence, non-rheumatic, etc.
Tabular List of Diseases and Injuries
The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code I36.1:
Inclusion Terms
Inclusion TermsThese terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
- Nonrheumatic tricuspid (valve) incompetence
- Nonrheumatic tricuspid (valve) regurgitation
Index to Diseases and Injuries
The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code I36.1 are found in the index:
- - Insufficiency, insufficient
- - tricuspid (valve) (rheumatic) - I07.1
- - nonrheumatic - I36.1
- - tricuspid (valve) (rheumatic) - I07.1
Approximate Synonyms
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Acute prosthetic tricuspid valve regurgitation
- Disorder of tricuspid valve prosthesis
- Functional tricuspid regurgitation
- Postprocedural regurgitation of tricuspid valve
- Prosthetic tricuspid valve regurgitation
- Tricuspid incompetence, non-rheumatic
- Tricuspid valve disorder, non-rheumatic
- Tricuspid valve regurgitation due to carcinoid tumor
Diagnostic Related Groups - MS-DRG Mapping
The ICD-10 code I36.1 is grouped in the following groups for version MS-DRG V39.0 What are Diagnostic Related Groups?
The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC). applicable from 10/01/2021 through 09/30/2022.
| MS-DRG | MS-DRG Title | MCD | Relative Weight |
|---|---|---|---|
| 306 | CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC | 05 | 1.5037 |
| 307 | CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC | 05 | 0.8684 |
The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.
Convert I36.1 to ICD-9 Code
The General Equivalency Mapping (GEM) crosswalk indicates an approximate mapping between the ICD-10 code I36.1 its ICD-9 equivalent. The approximate mapping means there is not an exact match between the ICD-10 code and the ICD-9 code and the mapped code is not a precise representation of the original code.
- 424.2 - Nonrheum tricusp val dis (Approximate Flag)
Information for Patients
Heart Valve Diseases
Your heart has four valves. Normally, these valves open to let blood flow through or out of your heart, and then shut to keep it from flowing backward. But sometimes they don't work properly. If they don't, you could have
- Regurgitation - when blood leaks back through the valve in the wrong direction
- Mitral valve prolapse - when one of the valves, the mitral valve, has "floppy" flaps and doesn't close tightly. It's one of the most common heart valve conditions. Sometimes it causes regurgitation.
- Stenosis - when the valve doesn't open enough and blocks blood flow
Valve problems can be present at birth or caused by infections, heart attacks, or heart disease or damage. The main sign of heart valve disease is an unusual heartbeat sound called a heart murmur. Your doctor can hear a heart murmur with a stethoscope. But many people have heart murmurs without having a problem. Heart tests can show if you have a heart valve disease. Some valve problems are minor and do not need treatment. Others might require medicine, medical procedures, or surgery to repair or replace the valve.
NIH: National Heart, Lung, and Blood Institute
[Learn More in MedlinePlus]
Code History
- FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
- FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
- FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
- FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
- FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
- FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)