# Valve disorders - coding Rheumatic vs Non-rheumatic



## JRhea0715 (Jun 21, 2016)

At a recent AAPC workshop, we were told to code rheumatic (as opposed to non-rheumatic) if a valve disorder/condition is not specified as rheumatic or non-rheumatic in the physician's dictation.  Is this accurate? If so, does anyone know where I can find this in the guidelines/IOM/etc?  Really appreciate the help. Thanks!


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## SDAlward (Jun 24, 2016)

These are tricky, it took me awhile to fully understand them.

Per a cardiology webinar I attended recently,  ICD assumes rheumatic.  If it is not specified as non rheumatic, assume rheumatic.  

For example, if you look at category I05, within "includes" it specifies "whether specified as rheumatic or not.

If more than one valve is involved (mitral regurgitation with aortic insufficiency) it is always coded as rheumatic.  See category I08

you would have to look in the index for each individual valve code, but if it is not specified as non rheumatic, then always assume rheumatic.  

Hope this made sense


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## JRhea0715 (Jun 27, 2016)

*Thank you!*



SDAlward said:


> These are tricky, it took me awhile to fully understand them.
> 
> Per a cardiology webinar I attended recently,  ICD assumes rheumatic.  If it is not specified as non rheumatic, assume rheumatic.
> 
> ...




Thank you so much for your response, and thank you for including references to the categories.  This really helped a lot. =)


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## satyaphani (Feb 14, 2018)

*valve disoders*

can any one suggest if  mitral valve prolapse and multiple valves like mitral, tricuspid , pulmonary regurgitation is present what are the diagnosis we need to capture.whether we need to capture rheumatic or non rheumatic.

Thank you


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## lovelyadd (Feb 15, 2018)

satyaphani said:


> can any one suggest if  mitral valve prolapse and multiple valves like mitral, tricuspid , pulmonary regurgitation is present what are the diagnosis we need to capture.whether we need to capture rheumatic or non rheumatic.
> 
> Thank you



At first, I was coding all separately, if it was just mitral (minus stenosis) and pulmonary; since per guidelines mitral prolapse, mitral reg. and any pulmonary conditions NOS are assumed non-rheumatic.  However, per our auditor anytime there is a combination with pulmonary valve to use I08.8. I could never find any documentation to support if either were correct/incorrect. Per guidelines to use the other combo codes (NOS) for mitral, aortic, and tricuspid etc. (I08.0, I08.1, I08.2, I08.3).


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## zharisma (Mar 7, 2018)

Default would be nonrheumatic.
I usually code them separately also for nonrheumatic. but if it is stated rheumatic there's a combi code I08.--

Hope that helps!


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