Mitral Valve Prolapse G023

Current RMA Instruments
Reasonable Hypothesis SOP
15 of 2023
Balance of Probabilities SOP
16 of 2023
Changes from previous Instruments

 ICD Coding

ICD-10-AM Code: I34.1

Brief description

This is a disorder of the mitral valve of the heart, where the valve prolapses into the atrium during ventricular contraction.  It may result in mitral regurgitation.  If so it is usually mild or trivial and more rarely may become severe.

Confirming the diagnosis

Echocardiography is required, with specific criteria used to establish the diagnosis.

The relevant medical specialist is a cardiologist.

Additional diagnoses covered by SOP
  • Barlow syndrome/disease
  • Floppy mitral valve (syndrome)
  • Mitral regurgitation in the presence of mitral valve prolapse, but excluding other causes.
Conditions excluded from SOP
  • Other heart valve disorders not affecting the mitral valve
  • Mitral stenosis#
  • Mitral valve disease in Marfan syndrome*
  • Mitral regurgitation in the absence of prolapse 
  • Rheumatic heart disease affecting the mitral valve*
  • Flail mitral valve leaflets#

* another SOP applies

non-SOP condition

Clinical onset

The condition does not have any reliable, specific symptoms. The first clinical evidence is likely to be a heart murmur heard on ascultation (via a stethescope). 

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  Mild disease requires no treatment beyond observation.  Severe mitral regurgitation may require surgery.

 

 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/mitral-valve-prolapse-g023-i341

Last amended

Rulebase for mitral valve prolapse

<h5>Current RMA Instruments</h5><table border="1" cellpadding="1" cellspacing="1"><tbody><tr><td><address><a href="http://www.rma.gov.au/assets/SOP/2023/19d5a181cb/015.pdf&quot; target="_blank">Reasonable Hypothesis SOP</a></address></td><td>15 of 2023</td></tr><tr><td><address><a href="http://www.rma.gov.au/assets/SOP/2023/19d5a181cb/015.pdf&quot; target="_blank">Balance of Probabilities SOP </a></address></td><td>16 of 2023</td></tr></tbody></table><h5>Changes from previous Instruments</h5><p><drupal-media data-entity-type="media" data-entity-uuid="34a771f0-c851-4903-b672-a0c608ef9fd9" data-view-mode="wysiwyg"></drupal-media></p><h5> ICD Coding</h5><p>ICD-10-AM Code: I34.1</p><h5>Brief description</h5><p>This is a disorder of the mitral valve of the heart, where the valve prolapses into the atrium during ventricular contraction.  It may result in mitral regurgitation.  If so it is usually mild or trivial and more rarely may become severe.</p><h5>Confirming the diagnosis</h5><p>Echocardiography is required, with specific criteria used to establish the diagnosis.</p><p>The relevant medical specialist is a cardiologist.</p><h5><strong>Additional diagnoses covered by SOP</strong></h5><ul><li>Barlow syndrome/disease</li><li>Floppy mitral valve (syndrome)</li><li>Mitral regurgitation in the presence of mitral valve prolapse, but excluding other causes.</li></ul><h5><strong>Conditions excluded from SOP </strong></h5><ul><li>Other heart valve disorders not affecting the mitral valve</li><li>Mitral stenosis<sup>#</sup></li><li>Mitral valve disease in Marfan syndrome*</li><li>Mitral regurgitation in the absence of prolapse </li><li>Rheumatic heart disease affecting the mitral valve*</li><li>Flail mitral valve leaflets<sup>#</sup></li></ul><p>* another SOP applies</p><p><sup># </sup>non-SOP condition</p><h5><strong>Clinical onset</strong></h5><p>The condition does not have any reliable, specific symptoms. The first clinical evidence is likely to be a heart murmur heard on ascultation (via a stethescope). </p><h5>Clinical worsening</h5><p>The only SOP worsening factor is for inability to obtain appropriate clinical management.  Mild disease requires no treatment beyond observation.  Severe mitral regurgitation may require surgery.</p><p> </p><p> </p>

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/rulebase-mitral-valve-prolapse

Inability to obtain appropriate clinical management for mitral valve prolapse

Current RMA Instruments
Reasonable Hypothesis SOP
15 of 2023
Balance of Probabilities SOP
16 of 2023
Changes from previous Instruments

 ICD Coding

ICD-10-AM Code: I34.1

Brief description

This is a disorder of the mitral valve of the heart, where the valve prolapses into the atrium during ventricular contraction.  It may result in mitral regurgitation.  If so it is usually mild or trivial and more rarely may become severe.

Confirming the diagnosis

Echocardiography is required, with specific criteria used to establish the diagnosis.

The relevant medical specialist is a cardiologist.

Additional diagnoses covered by SOP
  • Barlow syndrome/disease
  • Floppy mitral valve (syndrome)
  • Mitral regurgitation in the presence of mitral valve prolapse, but excluding other causes.
Conditions excluded from SOP
  • Other heart valve disorders not affecting the mitral valve
  • Mitral stenosis#
  • Mitral valve disease in Marfan syndrome*
  • Mitral regurgitation in the absence of prolapse 
  • Rheumatic heart disease affecting the mitral valve*
  • Flail mitral valve leaflets#

* another SOP applies

non-SOP condition

Clinical onset

The condition does not have any reliable, specific symptoms. The first clinical evidence is likely to be a heart murmur heard on ascultation (via a stethescope). 

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  Mild disease requires no treatment beyond observation.  Severe mitral regurgitation may require surgery.

 

 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/mitral-valve-prolapse-g023-i341/rulebase-mitral-valve-prolapse/inability-obtain-appropriate-clinical-management-mitral-valve-prolapse