Is I34.1 a billable ICD-10-CM code?

Yes. I34.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does I34.1 sit in the tabular list?

Diseases of the circulatory system (I00-I99), in the block Other forms of heart disease (I30-I5A).

What cannot be coded together with I34.1?

I34.1 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above I34.1 (I34) and apply to it just the same.

I34.1

I34.1 — Nonrheumatic mitral (valve) prolapse

Billable / specific codeICD-10-CM

I34.1 is a billable, specific ICD-10-CM code for nonrheumatic mitral (valve) prolapse. It is valid for submission on a claim.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

Marfan's syndrome (Q87.4-)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Floppy nonrheumatic mitral valve syndrome

Excludes1 inherited from the categories above I34.1

These are not written on I34.1, but they bind it: a note on a category applies to every code beneath it. Billing I34.1 with anything listed here is a denial.

Written on I34 — Nonrheumatic mitral valve disorders

mitral valve disease (I05.9)
mitral valve failure (I05.8)
mitral valve stenosis (I05.0)
mitral valve disorder of unspecified cause with diseases of aortic and/or tricuspid valve(s) (I08.-)
mitral valve disorder of unspecified cause with mitral stenosis or obstruction (I05.0)
mitral valve disorder specified as congenital (Q23.2, Q23.9)
mitral valve disorder specified as rheumatic (I05.-)

Other codes that can never be billed with I34.1

These codes carry an Excludes1 note pointing at I34.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading I34.1 alone.

I05Rheumatic mitral valve diseases

Risk adjustment

I34.1 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

I34.1 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 I34.1 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 I34.1.

Floppy›nonrheumatic mitral valve syndrome
Prolapse, prolapsed›mitral(valve)
Syndrome›floppy›mitral valve

Code history

I34.1 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share I34. If I34.1 is not quite right, the correct code is usually one of these.

Questions about I34.1

Is I34.1 a billable ICD-10-CM code?: Yes. I34.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does I34.1 sit in the tabular list?: Diseases of the circulatory system (I00-I99), in the block Other forms of heart disease (I30-I5A).
What cannot be coded together with I34.1?: I34.1 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above I34.1 (I34) and apply to it just the same.