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I36 ICD-10-CM Code: Nonrheumatic tricuspid valve disorders

ICD-10-CM Code View

HCC Buddy Code Card

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FY 2026 Apr update / Diseases of the circulatory system (I00-I99) / Other forms of heart disease (I30-I5A)

I36

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Nonrheumatic tricuspid valve disorders

Nonrheumatic tricuspid valve disorders

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
I3Other forms of heart disease (I30-I5A)
I36Nonrheumatic tricuspid valve disorders

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for I36 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for I36 in this effective period.

Related Child Codes

Official
I36.0Nonrheumatic tricuspid (valve) stenosis
I36.1Nonrheumatic tricuspid (valve) insufficiency
I36.2Nonrheumatic tricuspid (valve) stenosis with insufficiency
I36.8Other nonrheumatic tricuspid valve disorders
I36.9Nonrheumatic tricuspid valve disorder, unspecified

Includes

Official

ICD-10-CM does not list Includes notes for I36 in this effective period.

Excludes 1

Official
  • tricuspid valve disorders of unspecified cause (I07.-)
  • tricuspid valve disorders specified as congenital (Q22.4, Q22.8, Q22.9)
  • tricuspid valve disorders specified as rheumatic (I07.-)
  • tricuspid valve disorders with aortic and/or mitral valve involvement (I08.-)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for I36 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for I36 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for I36 in this effective period.

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Code
I36
Description
Nonrheumatic tricuspid valve disorders
HCC (V28)
No CMS-HCC V28 mapping
RAF
Billable
No
Payment year
2026

Coder workflow notes

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What This Code Means

I36 is the ICD-10-CM diagnosis code for nonrheumatic tricuspid valve disorders. I36 sits in the ICD-10-CM chapter for diseases of the circulatory system (i00-i99), within the section covering other forms of heart disease (i30-i5a).

Header codes like I36 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at I36's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for I36 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Excludes 1, Do NOT code together

  • tricuspid valve disorders of unspecified cause (I07.-)
  • tricuspid valve disorders specified as congenital (Q22.4, Q22.8, Q22.9)
  • tricuspid valve disorders specified as rheumatic (I07.-)
  • tricuspid valve disorders with aortic and/or mitral valve involvement (I08.-)

Child Codes

Code Hierarchy

I36Nonrheumatic tricuspid valve disorders
I36Nonrheumatic tricuspid valve disorders

Work I36 in HCC Buddy

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