Rheumatic tricuspid stenosis and insufficiency

This code signifies a dual valvular heart disease affecting the tricuspid valve, specifically characterized by both a narrowing (stenosis) and an incomplete closure (insufficiency or regurgitation) of the valve, resulting from rheumatic fever. This combined dysfunction impairs proper blood flow from the right atrium to the right ventricle.

Apply this code when documentation explicitly states a diagnosis of rheumatic tricuspid stenosis coexisting with rheumatic tricuspid insufficiency. This typically arises in patients with a history of rheumatic fever or rheumatic heart disease. Supporting documentation should include echocardiogram findings confirming both conditions and a clear etiology linking them to rheumatic disease.

• Ensure documentation specifies both stenosis and insufficiency; if only one is present, a different code is required.
• Verify the rheumatic etiology; if the cause is non-rheumatic, a different code from the I34 category would be more appropriate.
• Consider sequencing if other rheumatic heart conditions are present; typically, the most severe or primary condition is listed first.