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Reader Questions: Report Aortic/Mitral Valve Condition With 1 ICD-9 Code

Question: Our ED physician conducted a 12-lead electrocardiogram (ECG) on a patient diagnosed with stenosis in the aortic and mitral valves. What would be the correct coding for this scenario? Specifically, how many ICD-9 codes should I report for the patient?

Arkansas Subscriber

Answer: You鈥檒l use one diagnosis code to represent the stenosis in both valves.

When patients have stenosis (or another condition) in the mitral and aortic valves, you should choose a code from the 396.x series (Diseases of mitral and aortic valves) to identify both conditions.

Aortic stenosis does have its own ICD-9 code, 424.1 (Aortic valve disorders).

But the exclusions section for 424.1 states that the diagnosis does not include 鈥渢hat of unspecified cause but with mention of diseases of mitral valve (396.0-396.9).鈥�

ICD-9 coding: The proper ICD-9 code for your claim is 396.0 (Mitral valve stenosis and aortic valve stenosis).

CPT coding: Choose from one of these ECG codes, depending on the encounter鈥檚 specifics:

 鈥� 93000 -- Electrocardio-gram, routine ECG with at least 12 leads; with interpretation and report

 鈥� 93005 -- ... tracing only, without interpretation and report

 鈥� 93010 -- ... interpretation and report.

In the ED setting, you will likely report 93010 for the professional component of the interpretation and report because the facility will bill for the tracing (93005).

 -- Reader Questions reviewed by Sarah L. Goodman, MBA, CPC-H, CCP, president of SLG Inc. in Raleigh, N.C.