ICD Code I35.1

ICD code I35.1 is used to identify and classify the condition known as nonrheumatic aortic valve insufficiency. This condition occurs when the aortic valve in the heart does not close properly, leading to the backward flow of blood from the aorta into the left ventricle. Unlike rheumatic aortic insufficiency, which is caused by rheumatic fever, nonrheumatic aortic insufficiency can result from other factors such as congenital valve defects, age-related changes, or other non-rheumatic diseases. This code is essential for healthcare providers to accurately document and manage the diagnosis for billing, treatment planning, and statistical purposes.

1. Presence of Aortic Valve Insufficiency: The patient must exhibit signs of aortic valve insufficiency, which is characterized by the inability of the aortic valve to close properly, leading to the backflow of blood from the aorta into the left ventricle during diastole.

2. Nonrheumatic Origin: The insufficiency should not be attributed to rheumatic heart disease. It is essential to rule out rheumatic fever or rheumatic heart disease as the underlying cause.

3. Echocardiographic Evidence: Diagnostic imaging, such as an echocardiogram, should confirm the presence of aortic valve insufficiency. This imaging will typically show regurgitation of blood through the aortic valve.

4. Clinical Symptoms: The patient may present with symptoms such as shortness of breath, fatigue, palpitations, or chest pain. These symptoms are often due to the heart's increased workload as it compensates for the inefficiency of the valve.

5. Physical Examination Findings: A healthcare provider may detect a diastolic murmur upon auscultation of the heart, which is indicative of aortic regurgitation.

6. Exclusion of Congenital Causes: The insufficiency should not be due to congenital heart defects. It is important to differentiate nonrheumatic aortic insufficiency from congenital conditions that may affect the aortic valve.

7. Exclusion of Infective Endocarditis: The condition should not be caused by infective endocarditis, which can also lead to valve damage and insufficiency.

8. Exclusion of Traumatic Causes: Any history of trauma leading to valve damage should be ruled out as the cause of the insufficiency.

9. Exclusion of Degenerative Changes: While degenerative changes can lead to valve insufficiency, the specific ICD code is used when these changes are not the primary cause.

By adhering to these diagnostic criteria, healthcare providers can accurately determine when to use the specific ICD code for nonrheumatic aortic valve insufficiency.

For the ICD code I35.1, which pertains to nonrheumatic aortic (valve) insufficiency, the relevant CPT codes that may be applicable for treatment include:

1. 33405 - Replacement, aortic valve, with cardiopulmonary bypass; with prosthetic valve other than homograft or stentless valve.

2. 33406 - Replacement, aortic valve, with cardiopulmonary bypass; with stentless tissue valve.

3. 33410 - Replacement, aortic valve, with cardiopulmonary bypass; with homograft valve.

4. 33411 - Replacement, aortic valve, with cardiopulmonary bypass; with autograft valve (Ross procedure).

5. 33412 - Replacement, aortic valve, with transcatheter approach (TAVR/TAVI).

6. 33415 - Valvuloplasty, aortic valve; open, with cardiopulmonary bypass.

7. 33416 - Valvuloplasty, aortic valve; open, with cardiopulmonary bypass, with prosthetic ring.

8. 33418 - Transcatheter aortic valve implantation (TAVI/TAVR) with prosthetic valve; percutaneous femoral artery approach.

9. 33419 - Transcatheter aortic valve implantation (TAVI/TAVR) with prosthetic valve; open femoral artery approach.

These CPT codes are typically used in procedures aimed at addressing the condition associated with ICD code I35.1. It's important for healthcare providers to select the appropriate CPT code based on the specific procedure performed.

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