I34.0 — Nonrheumatic mitral (valve) insufficiency
I34.0 is a billable, specific ICD-10-CM code for nonrheumatic mitral (valve) insufficiency. It is valid for submission on a claim.
Code also
Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.
- , if applicable:
- nonrheumatic mitral (valve) annulus calcification (I34.81)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Nonrheumatic mitral (valve) incompetence NOS
- Nonrheumatic mitral (valve) regurgitation NOS
Other codes that can never be billed with I34.0
These codes carry an Excludes1 note pointing at I34.0. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading I34.0 alone.
- I05.1Rheumatic mitral insufficiency
Risk adjustment
I34.0 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
I34.0 is named in 32 Medicare coverage policies — 32 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 I34.0 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 I34.0.
- Insufficiency, insufficient›mitral(valve)
- Incompetency, incompetent, incompetence›annular›mitral(valve)
- Insufficiency, insufficient›mitral›specified cause, except rheumatic
Related codes at this level
Codes that share I34. If I34.0 is not quite right, the correct code is usually one of these.
Questions about I34.0
- Is I34.0 a billable ICD-10-CM code?
- Yes. I34.0 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does I34.0 sit in the tabular list?
- Diseases of the circulatory system (I00-I99), in the block Other forms of heart disease (I30-I5A).