Mitral stenosis with insufficiency

This code signifies a complex valvular heart disease where the mitral valve is both narrowed (stenosis) and fails to close properly (insufficiency or regurgitation). This dual pathology impairs blood flow from the left atrium to the left ventricle and causes backflow, leading to increased pressure and potential heart failure.

Apply this code when documentation explicitly states the presence of both mitral stenosis and mitral insufficiency. This typically arises from echocardiogram findings, cardiac catheterization reports, or physician notes detailing both obstructive and regurgitant flow across the mitral valve.

• Ensure documentation clearly specifies both stenosis and insufficiency of the mitral valve; do not code if only one condition is present.
• Distinguish from codes for isolated mitral stenosis or isolated mitral insufficiency.
• Consider sequencing with codes for associated conditions like heart failure or atrial fibrillation, if documented.