Resources for Professional Component Coding of Echocardiograms


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New to Cardiology Coding and looking for a resource (book or internet based) to assist with diagnostic coding of the professional component for Echocardiograms. Needing coding/billing guidance.

We have an example of Aortic Sclerosis without Stenosis, our Optum Coding drills us down to Q25.3 for Supravalvular Aortic Stenosis.

Another example is: Mod AV Sclerosis; Mild WA/WDD; and Mild TR

AV Sclerosis directs us to Endocarditis, which then wants us to drill down to non-rheumatic or rheumatic with mitral disease or tricuspid disease.

Any help would be appreciated.

Thank you,



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One of the best internet-based resources I have found is from CMS (they did an entire series for the Road to 10, featuring prominent guideline changes and common codes for each of the chapters in ICD-10-CM). Here is the link to the presentation for cardiology:

I think one of the biggest shifts for heart valve disease coding is the presumption of rheumatic valve disease when you have multiple diseased valves where the disease is of unspecified origin. For example, one of the scenarios you presented for aortic valve stenosis and tricuspid valve regurgitation, if the provider does not specify rheumatic vs. non-rheumatic, your default code is I08.2. To arrive, there, start in your index under regurgitation which will redirect you to insufficiency; then reference the subentry "tricuspid valve" then "with aortic valve disease" which takes you to I08.2. In the tabular section, under category I08, you will see an includes note that states "multiple valve diseases specified as rheumatic or unspecified" which is confirmation that multiple valve diseases of unspecified origin default to this category I08. Also as additional confirmation if you look in the tabular section under category I35 for nonrheumatic aortic valve disorders, you will see an excludes 1 note which states "aortic valve disorders of unspecified cause but with diseases of mitral and/or tricuspid valves (I08.-) which directs you back to category I08. The key to accurate coding for these conditions is making sure you follow your documentation and your guidelines including your index redirects and includes/excludes notes as you are coding for heart valve disease :).

As one additional resource suggestion, if you can gain access to the AHA Coding Clinic archives, they have a lot of great articles for ICD-10-CM and further explain some of the guidelines that are new/challenging. I hope that helps!