Nonrheumatic aortic (valve) insufficiency

This code signifies a condition where the aortic valve does not close properly, leading to a backflow of blood into the left ventricle during diastole. This insufficiency is not caused by rheumatic fever or rheumatic heart disease. It can result in symptoms such as shortness of breath, fatigue, and chest pain.

Use this code when documentation clearly indicates aortic regurgitation or insufficiency that is explicitly stated as nonrheumatic in origin. This includes cases where the etiology is congenital, degenerative, traumatic, or infectious (e.g., endocarditis) but not rheumatic. Supporting documentation would include echocardiogram reports, physician notes detailing the diagnosis, and absence of a rheumatic fever history.

• Differentiate carefully between rheumatic and nonrheumatic etiologies; if rheumatic, a different code from the I05 series would be appropriate.
• Do not use this code for aortic stenosis or other aortic valve disorders without insufficiency.
• Always look for documentation of the underlying cause of the nonrheumatic insufficiency, as additional codes may be necessary for complete specificity.