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I37.1

Billable

Nonrheumatic pulmonary valve insufficiency

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

Leakage of the pulmonary valve (the valve controlling blood flow from the right ventricle to the lungs) that is not caused by rheumatic fever, allowing blood to flow backward.

Coding Tips

  • •Ensure documentation specifies insufficiency without stenosis; if both are present, use I37.2 instead
  • •Verify the nonrheumatic origin of the valve insufficiency

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