I05.0 — Rheumatic mitral stenosis
I05.0 is a billable, specific ICD-10-CM code for rheumatic mitral stenosis. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Mitral (valve) obstruction (rheumatic)
Other codes that can never be billed with I05.0
These codes carry an Excludes1 note pointing at I05.0. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading I05.0 alone.
- I34Nonrheumatic mitral valve disorders
Risk adjustment
I05.0 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
I05.0 is named in 25 Medicare coverage policies — 25 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
- A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
- A52868Billing and Coding: Transesophageal Echocardiography (TEE)
- A52868Billing and Coding: Transesophageal Echocardiography (TEE)
How I05.0 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to I05.0.
- Stenosis, stenotic›mitral(chronic) (inactive) (valve)
Related codes at this level
Codes that share I05. If I05.0 is not quite right, the correct code is usually one of these.
Questions about I05.0
- Is I05.0 a billable ICD-10-CM code?
- Yes. I05.0 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does I05.0 sit in the tabular list?
- Diseases of the circulatory system (I00-I99), in the block Chronic rheumatic heart diseases (I05-I09).