Rheumatic tricuspid insufficiency

This code describes a condition where the tricuspid valve, located between the right atrium and right ventricle of the heart, fails to close properly due to damage caused by rheumatic fever. This improper closure leads to a backflow of blood into the right atrium during ventricular contraction, resulting in tricuspid regurgitation.

Use this code when documentation explicitly states tricuspid insufficiency or regurgitation and clearly links it to a history of rheumatic fever. This diagnosis is typically made based on echocardiographic findings and a patient's medical history.

• Ensure documentation specifies "rheumatic" as the etiology; otherwise, a non-rheumatic tricuspid insufficiency code would be more appropriate.
• Code any associated heart failure or pulmonary hypertension separately, as these are common complications.
• Review the patient's history for evidence of rheumatic fever to support the "rheumatic" designation.