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.
Check I34.1 with the rest of the claim: free scrubberExcludes1: 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
A category’s note binds every code beneath it.
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
Their own Excludes1 notes name this code, so the conflict is not listed above.
- I05Rheumatic mitral valve diseases
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
I34.1 is named in 21 Medicare coverage policies: 21 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
- A52868Billing and Coding: Transesophageal Echocardiography (TEE)
- A52992Billing and Coding: Non-Invasive Cerebrovascular Arterial Studies
- A56423Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing
Alphabetic index entries that lead here
- Floppy›nonrheumatic mitral valve syndrome
- Prolapse, prolapsed›mitral(valve)
- Syndrome›floppy›mitral valve
Code history
Unchanged in every release from FY2024 to FY2027.