I37.1 — Nonrheumatic pulmonary valve insufficiency
I37.1 is a billable, specific ICD-10-CM code for nonrheumatic pulmonary valve insufficiency. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Nonrheumatic pulmonary valve incompetence
- Nonrheumatic pulmonary valve regurgitation
Risk adjustment
I37.1 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
I37.1 is named in 24 Medicare coverage policies — 24 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)
- A56423Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing
- A56476Billing and Coding: Cardiac Radionuclide Imaging
How I37.1 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 I37.1.
- Incompetency, incompetent, incompetence›pulmonary valve(heart)
- Murmur›Graham Steell
- Regurgitation›pulmonary(valve) (heart)
- Incompetency, incompetent, incompetence›annular›pulmonary valve(heart)
- Insufficiency, insufficient›pulmonary›valve
Related codes at this level
Codes that share I37. If I37.1 is not quite right, the correct code is usually one of these.
Questions about I37.1
- Is I37.1 a billable ICD-10-CM code?
- Yes. I37.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does I37.1 sit in the tabular list?
- Diseases of the circulatory system (I00-I99), in the block Other forms of heart disease (I30-I5A).