ICD-10-CM Code I36.1

Valid for Submission

I36.1 is a billable code used to specify a medical diagnosis of nonrheumatic tricuspid (valve) insufficiency. The code is valid for the year 2020 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 cardiac valve regurgitation, prosthetic tricuspid valve regurgitation, 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 guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code I36.1:

Inclusion Terms

Inclusion Terms
These 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

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 cardiac valve regurgitation
• Prosthetic tricuspid valve regurgitation
• Tricuspid incompetence, non-rheumatic
• Tricuspid valve disorder, non-rheumatic
• Tricuspid valve regurgitation due to carcinoid tumor

Diagnostic Related Groups

The ICD-10 code I36.1 is grouped in the following groups for version MS-DRG V37.0 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 10/01/2019 through 09/30/2020.

• 306 - CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC
• 307 - CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC

Convert I36.1 to ICD-9

• 424.2 - Nonrheum tricusp val dis (Approximate Flag)

Code Classification

• Diseases of the circulatory system (I00–I99)
  • Other forms of heart disease (I30-I52)
    • Nonrheumatic tricuspid valve disorders (I36)

Code History

• FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
  (First year ICD-10-CM implemented into the HIPAA code set)
• FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
• FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
• FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
• FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020

Tools

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• Convert I36.1 to ICD-9