I36.1
I36.1: Nonrheumatic tricuspid (valve) insufficiency
Billable / specific codeICD-10-CM
I36.1 is a billable, specific ICD-10-CM code for nonrheumatic tricuspid (valve) insufficiency. It is valid for submission on a claim.
Check I36.1 with the rest of the claim: free scrubberInclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Nonrheumatic tricuspid (valve) incompetence
- Nonrheumatic tricuspid (valve) regurgitation
Excludes1 inherited from the categories above I36.1
A category’s note binds every code beneath it.
Written on I36: Nonrheumatic tricuspid valve disorders
Other codes that can never be billed with I36.1
Their own Excludes1 notes name this code, so the conflict is not listed above.
- I07Rheumatic tricuspid valve diseases
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
I36.1 is named in 16 Medicare coverage policies: 16 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)
- A56423Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing
- A56476Billing and Coding: Cardiac Radionuclide Imaging
Alphabetic index entries that lead here
- Insufficiency, insufficient›tricuspid›nonrheumatic
Code history
Unchanged in every release from FY2024 to FY2027.