Nonrheumatic pulmonary valve stenosis with insufficiency

This diagnosis code represents a condition where the pulmonary valve, which controls blood flow from the heart to the lungs, is both narrowed (stenosis) and leaky (insufficiency). This dysfunction is not due to rheumatic fever but rather other causes, leading to impaired blood flow dynamics in the right side of the heart.

Assign this code when documentation clearly indicates a nonrheumatic etiology for combined pulmonary valve stenosis and insufficiency. This diagnosis is typically supported by echocardiogram findings, cardiac catheterization reports, and physician notes detailing both the narrowing and regurgitation of the pulmonary valve.

• Ensure the documentation explicitly states "nonrheumatic" to differentiate from rheumatic etiologies.
• Do not use this code if only stenosis or only insufficiency is present; a combined defect is required.
• Verify that the physician's notes confirm both components of the valve dysfunction.