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Rheumatic Heart Disease G008
In this section
Current RMA Instruments:
|Reasonable Hypothesis SOP||19 of 2011|
|Balance of Probabilities SOP||20 of 2011|
Changes from Previous Instruments:
- ICD-9-CM Codes: 393 - 398
- ICD-10-AM Codes: I05, I06, I07, I08, I09
Rheumatic heart disease is chronic damage to the heart, particularly heart valves, due to acute rheumatic fever in the past.
Is specific diagnostic evidence required to apply the SOP? – No.
Are there sub-factors that require specific information? – No.
Additional diagnoses covered by SOP
- rheumatic aortic valve incompetence or stenosis
- rheumatic mitral valve incompetence or stenosis
- rheumatic pulmonary valve disease
- rheumatic tricuspid valve incompetence or stenosis
- chronic rheumatic myocarditis
- chronic rheumatic pericarditis
Conditions not covered by SOP
- Acute rheumatic fever, ICD9 codes 390-2
- Acute rheumatic carditis, ICD9 code 391
- Recurrent acute rheumatic fever, ICD9 codes 390-2
- Any heart valve disease not due to past rheumatic fever, e.g.:
- non-rheumatic aortic stenosis, ICD9 code 424.1
- non-rheumatic mitral incompetence, ICD9 code 424.0
If, after applying the above information, you are unable to confirm the diagnosis, you should then:
- seek medical officer advice about further investigation, or;
- generate a diagnostic report, or;
- re-encode the condition, if appropriate.
The following investigations may be useful in establishing the diagnosis.
- Report of echocardiogram
- Report from cardiologist