Published on November 18, 2018
slide 1: Billing and Coding Mitral Regurgitation for Optimal Reimbursement Mitral regurgitation occurs when the mitral heart valve does not close properly. The article lists the ICD-10 codes for this condition. Outsource Strategies International Headquarters: 8596 E. 101st Street Suite H Tulsa OK 74133 slide 2: www.outsourcestrategies.com 918-221-7769 Regarded as one of the most common types of heart valve disorder Mitral valve regurgitation is a condition in which the mitral valve does not close tightly when the heart pumps out blood. Generally blood that flows between different chambers of your heart must flow through a valve. The valve between the two chambers on the left side of your heart is called the mitral valve. When the mitral valve doesn’t close properly blood flows backward into the upper heart chambers atrium from the lower chamber as it contracts. This backflow causes a pressure or volume overload in the upper atrium eventually causing lung vessel congestion. In addition the amount of blood that flows to the rest of the body is also reduced. As a result the heart may try to pump harder causing congestive heart failure. Treatment for this heart valve disorder depends on the type of symptoms and severity of the condition. For mild leakage treatment is usually not necessary. In more severe cases a heart surgery to repair or replace the valve may be required. As there are several coding rules related to reporting this heart condition cardiology medical billing and coding can be complex. Outsourcing medical billing services to an experienced provider is a reliable slide 3: www.outsourcestrategies.com 918-221-7769 strategy to ensure accurate and timely claim filing and reimbursement. Also called mitral insufficiency or mitral incompetence this condition can be caused by problems or damages within the mitral valve. This can be either from birth or because of a heart attack which can weaken the tissue around it. Other possible causes include – damaged tissue cords rheumatic fever valve prolapse trauma abnormality of the heart muscle cardiomyopathy atrial fibrillation endocarditis radiation therapy and prolonged use of certain medications. Common Signs and Symptoms to Notice With the slow progressive nature of mitral insufficiency it may take years for the symptoms to develop and patients in most cases are asymptomatic during the initial stages and may be unaware that they suffer from this condition. However in some cases the problem develops quickly and the patients may experience a sudden onset of severe signs and symptoms. Signs and symptoms of mitral valve regurgitation may mainly depend on its severity and how quickly the condition develops and can include– slide 4: www.outsourcestrategies.com 918-221-7769 Abnormal heart sound or heart murmur heard through a stethoscope Chest pain Coughing Edema Severe fluid retention in the legs or abdomen Fatigue Heart palpitations — sensations of a rapid fluttering heartbeat Shortness of breath dyspnea especially when you have been very active or when you lie down Swelling of legs and feet How Is Mitral Regurgitation Diagnosed and Treated Cardiologists generally diagnose the valve problem by sound. If blood is flowing back into the left atrium it will produce a murmur or whooshing sound. The abnormal heart murmur can be heard through stethoscope examination. The physician will conduct a detailed analysis of previous medical history and check whether you have a family history of heart disease. Several imaging tests like Echocardiogram Chest X-ray ElectrocardiogramECG Cardiac MRI and CT Cardiac slide 5: www.outsourcestrategies.com 918-221-7769 catheterization and exercise tests or stress tests will be performed to confirm the diagnosis of mitral insufficiency. Treatment for this condition aims to improve your hearts function while reducing your signs and symptoms and avoiding future complications. Treatment options may depend on the type of symptoms condition severity and include medications diuretics blood thinners and high blood pressure medications Intra-aortic balloon pump a device will be placed in the thoracic aorta to increase blood flow and mitral valve repair or replacement surgery. Cardiology medical coding involves using the specific ICD-10 diagnosis codes for reporting mitral valve regurgitation on the medical claims physicians submit to health insurers for reimbursement. ICD-10 codes to use for “Mitral Valve Regurgitation” include – I34 - Nonrheumatic mitral valve disorders 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 slide 6: www.outsourcestrategies.com 918-221-7769 I34.9 - Nonrheumatic mitral valve disorder unspecified Incorporating a number of heart-healthy lifestyle changes into your life such as keeping blood pressure under control maintaining a healthy body weight getting involved in regular physical activity consuming a heart-healthy diet avoiding use of tobacco and alcohol and preventing infective endocarditis can help prevent the incidence of this condition in the long run. Medical billing and coding for different heart valvedisorders can be difficult. For accurate and timely medical billing and claims submission healthcare practices can outsource their medical coding tasks to a reputable medical billing company that provides the services of AAPC-certified coding specialists.