I36.2 — Nonrheumatic tricuspid (valve) stenosis with insufficiency
I36.2 is a billable, specific ICD-10-CM code for nonrheumatic tricuspid (valve) stenosis with insufficiency. It is valid for submission on a claim.
Excludes1 inherited from the categories above I36.2
These are not written on I36.2, but they bind it: a note on a category applies to every code beneath it. Billing I36.2 with anything listed here is a denial.
Written on I36 — Nonrheumatic tricuspid valve disorders
Other codes that can never be billed with I36.2
These codes carry an Excludes1 note pointing at I36.2. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading I36.2 alone.
- I07Rheumatic tricuspid valve diseases
Risk adjustment
I36.2 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
I36.2 is named in 23 Medicare coverage policies — 23 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
- A52868Billing and Coding: Transesophageal Echocardiography (TEE)
- A52868Billing and Coding: Transesophageal Echocardiography (TEE)
- A56423Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing
How I36.2 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 I36.2.
- Insufficiency, insufficient›tricuspid›nonrheumatic›with stenosis
- Stenosis, stenotic›tricuspid›nonrheumatic›with insufficiency
Code history
I36.2 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 I36. If I36.2 is not quite right, the correct code is usually one of these.
Questions about I36.2
- Is I36.2 a billable ICD-10-CM code?
- Yes. I36.2 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does I36.2 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 I36.2?
- I36.2 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 I36.2 (I36) and apply to it just the same.