Nonrheumatic tricuspid (valve) stenosis with insufficiency

This code represents a congenital or acquired narrowing of the tricuspid valve opening, which impedes blood flow from the right atrium to the right ventricle, combined with the inability of the tricuspid valve to close completely, leading to backflow of blood into the right atrium during ventricular contraction. This condition is not caused by rheumatic fever.

Use this code when documentation specifies both tricuspid stenosis and tricuspid insufficiency (regurgitation) that are nonrheumatic in origin. This applies to patients diagnosed with combined tricuspid valve disease, often identified through echocardiography showing both restricted valve opening and regurgitant flow.

• Ensure documentation explicitly states both "stenosis" and "insufficiency" (or "regurgitation") of the tricuspid valve.
• Verify that the etiology is clearly documented as "nonrheumatic" or no rheumatic cause is mentioned.
• Do not use this code if only stenosis or only insufficiency is present; separate codes exist for isolated conditions.