Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerBilling CodesOther forms of heart diseaseICD-10-CM i36-nonrheumatic-tricuspid-valve-disorders
    Ask Trek AI about this page

    ICD-10-CM Code For Nonrheumatic Tricuspid Valve Disorders: Group Overview

    The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group I36 includes nonrheumatic tricuspid valve disorders such as tricuspid regurgitation and tricuspid stenosis, covering conditions that impair tricuspid valve function and right-sided heart performance. These ICD-10-CM diagnosis codes are used to document clinical scenarios including valve dysfunction severity, presence of right heart failure signs, and associated hemodynamic impact. Accurate coding within the ICD-10-CM I36 group supports proper claim adjudication, complete clinical documentation, and appropriate reimbursement.

    Customize your policy alerts

    Sign up for ICD-10-CM Code For Nonrheumatic Tricuspid Valve Disorders: Group Overview policy alerts

    Get alerted when relevant policies change without checking for updates manually.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    ICD-10-CM I36: Nonrheumatic Tricuspid Valve Disorders Overview

    This group includes nonrheumatic disorders of the tricuspid valve such as tricuspid regurgitation and tricuspid stenosis, which affect right-sided heart valve function. These conditions target the cardiovascular system and can lead to right heart failure, fluid overload, and reduced cardiac output. Accurate coding of these diagnoses is important for correct reimbursement, quality measurement, and continuity of care.

    Table of contents

    Progress1 / 6

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    When to Use

    Use a code from this group when the clinical record documents nonrheumatic dysfunction of the tricuspid valve such as regurgitation or stenosis. Select the code that reflects the specific valve lesion and any documented severity or associated right heart complications.

    ICD-10-CM Codes

    5 rows

    ICD-10-CM CodeDescription
    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

    DRG Codes

    2 rows

    DRG CodeDescription
    306Cardiac Congenital and Valvular Disorders with MCC
    307Cardiac Congenital and Valvular Disorders without MCC

    Typical Clinical Scenarios

    • An elderly patient with progressive exertional fatigue, peripheral edema, and hepatomegaly is seen in cardiology clinic; echocardiography shows severe tricuspid regurgitation without evidence of rheumatic disease, and no other primary right-sided valve lesions. This chronic valvular insufficiency is attributed to primary tricuspid valve structural abnormality or degenerative change, prompting assignment of a nonrheumatic tricuspid valve disorder code. Typical codes: I36.1

    • An adult presents to the emergency department with sudden worsening dyspnea, hypotension, and signs of right-sided volume overload after an episode of infective endocarditis; echocardiography demonstrates acute severe tricuspid regurgitation due to leaflet perforation. This acute, complication-driven presentation of tricuspid valve dysfunction is coded as a nonrheumatic tricuspid valve disorder reflecting the valve lesion causing the hemodynamic compromise. Typical codes: I36.0, I36.8

    • A patient with long-standing left-sided heart failure is admitted for management of progressive ascites and jugular venous distension; evaluation reveals functional tricuspid regurgitation from annular dilation secondary to right ventricular enlargement. Because the tricuspid valve insufficiency is nonrheumatic and secondary to ventricular remodeling, a code from the nonrheumatic tricuspid valve disorders group is applied as a comorbid cardiac condition. Typical codes: I36.9, I36.1

    Related Codes

    I30-ACUTE-PERICARDITIS

    ICD-10-CM Code For Acute Pericarditis: Group Overview

    I31-OTHER-DISEASES-OF-PERICARDIUM

    ICD-10-CM Code For Other Diseases Of Pericardium: Group Overview

    I32-PERICARDITIS-IN-DISEASES-CLASSIFIED-ELSEWHERE

    ICD-10-CM Code For Pericarditis In Diseases Classified Elsewhere: Group Overview

    I33-ACUTE-AND-SUBACUTE-ENDOCARDITIS

    ICD-10-CM Code For Acute And Subacute Endocarditis: Group Overview

    I34-NONRHEUMATIC-MITRAL-VALVE-DISORDERS

    ICD-10-CM Code For Nonrheumatic Mitral Valve Disorders: Group Overview

    I35-NONRHEUMATIC-AORTIC-VALVE-DISORDERS

    ICD-10-CM Code For Nonrheumatic Aortic Valve Disorders: Group Overview

    I37-NONRHEUMATIC-PULMONARY-VALVE-DISORDERS

    ICD-10-CM Code For Nonrheumatic Pulmonary Valve Disorders: Group Overview

    I38-ENDOCARDITIS-VALVE-UNSPECIFIED

    ICD-10-CM Code For Endocarditis Valve Unspecified: Group Overview

    I39-ENDOCARDITIS-AND-HEART-VALVE-DISORDERS

    ICD-10-CM Code For Endocarditis And Heart Valve Disorders In Diseases Classified Elsewhere: Group Overview

    I40-ACUTE-MYOCARDITIS

    ICD-10-CM Code For Acute Myocarditis: Group Overview

    Showing 1–10 of 23

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
    Published by

    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.