Cardiology Coding Alert

Reader Question:

Mitral Valve Replacement

Question: What is the diagnosis code for mitral valve replacement?

Texas Subscriber

Answer: There are two V codes that describe the replacement of a heart valve, says Terry Fletcher, BS, CPC, CCS-P, an independent cardiology coding and reimbursement specialist in Dana Point, Calif. Code V43.3 (organ or tissue replaced by other means; heart valve) should be used if the valve is replaced by an artificial or mechanical device, whereas V42.2 (organ or tissue replaced by transplant; heart valve) is correct if the valve is replaced with either human or animal (usually porcine) valves.

Two ICD-9 codes, meanwhile, describe the disease that prompted the replacement of the valves. For patients with rheumatic involvement that does not include the aortic valve, 394.x (diseases of mitral valve) should be used. For patients without rheumatic involvement, use 424.0 (mitral valve disorders).