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I34.0 vs I34.81

I34.0 (Nonrheumatic mitral (valve) insufficiency) compared with I34.81 (Nonrheumatic mitral (valve) annulus calcification), from the official CMS tabular data.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Summary

These codes may both be needed to describe one condition, because I34.0 carries a Code Also note covering I34.81.

Official rule
What is different?

Title wording.The titles share “Nonrheumatic mitral (valve)”; I34.0 says “insufficiency” where I34.81 says “annulus calcification”.

Registry fact

Can these codes be reported together?

Yes, and both may be needed.I34.0 carries a Code Also note covering I34.81: “nonrheumatic mitral (valve) annulus calcification (I34.81)”. The two may both be required to fully describe the condition; the note states no sequencing order.

Official ruleGuide: Code First vs Use Additional Code vs Code Also

Are there sequencing instructions?

No order is given.The Code Also note linking them states no sequencing order; sequence by the reason for the encounter.

Official ruleGuide: Code First vs Use Additional Code vs Code Also

Are there other coding relationships?

Yes.Both codes may be needed together. I34.0 carries a Code Also note covering I34.81: “nonrheumatic mitral (valve) annulus calcification (I34.81)”

Official ruleGuide: Code First vs Use Additional Code vs Code Also

Nothing found in 4 other checks
Is there an Excludes1 relationship?

None.Neither entry carries an Excludes1 note that names the other code. I34.0 carries 7 Excludes1 notes and I34.81 carries 7 Excludes1 notes covering other codes; the side-by-side table quotes them.

Official rule

Is there an Excludes2 relationship?

None.Neither entry carries an Excludes2 note that names the other code.

Official rule

Is one more specific?

No.Neither is a subdivision of the other, and neither title is the unspecified form; they describe different conditions within category I34.

Registry fact

Is one a parent or header code?

No.Both are billable codes, and neither contains the other.

Registry fact

Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule. How to read the labels

Can these codes be reported together?

Informational

Code Also relationship

I34.0
Nonrheumatic mitral (valve) insufficiency
↔
I34.81
Nonrheumatic mitral (valve) annulus calcification

What we found

Both codes may be needed together.I34.0 carries a Code Also note covering I34.81: “nonrheumatic mitral (valve) annulus calcification (I34.81)”

A Code Also note means the two codes may both be required to fully describe the condition. CMS states no sequencing order for it — sequence by the reason for the encounter.

What to review

Report both when both are needed to describe the condition, sequenced by the reason for the encounter.

Guide: Code First vs Use Additional Code vs Code AlsoCheck these on a claim

Why it matters

A "Code Also" note means two codes may be required together, but the Guidelines state no sequencing order for it -- sequence by the reason for the encounter, not by this relationship.

Source / rule

CMS ICD-10-CM tabular instructional notes

Official guidance behind these answers

  • Section I.A.17 — “Code also ” note · applies to: Code also

    A “code also” note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction. The sequencing depends on the circumstances of the encounter.

    ICD-10-CM Official Guidelines FY2027

Quoted from the ICD-10-CM Official Guidelines for Coding and Reporting in effect for the release shown. The tabular notes above are the code-level instruction; these sections are the convention that says how such a note is applied. Source document (CMS PDF) · Release and checksum

Side by side

Similar descriptions do not make codes interchangeable. The documentation and the official instructions decide which code applies.

Official descriptionDiffers
I34.0

Nonrheumatic mitral (valve) insufficiency

I34.81

Nonrheumatic mitral (valve) annulus calcification

StatusSame for both
Billable
Excludes1Same for both
  • mitral valve disease (I05.9)
  • mitral valve failure (I05.8)
  • mitral valve stenosis (I05.0)
  • mitral valve disorder of unspecified cause with diseases of aortic and/or tricuspid valve(s) (I08.-)
  • mitral valve disorder of unspecified cause with mitral stenosis or obstruction (I05.0)
  • mitral valve disorder specified as congenital (Q23.2, Q23.9)
  • mitral valve disorder specified as rheumatic (I05.-)
Code alsoDiffers
Only at I34.0
  • nonrheumatic mitral (valve) annulus calcification (I34.81)
Only at I34.81
  • nonrheumatic mitral (valve) insufficiency (I34.0)
  • nonrheumatic mitral (valve) stenosis (I34.2)
Shared by both codes (1 note)
  • , if applicable:
CategorySame for both

I34 Nonrheumatic mitral valve disorders

ChapterSame for both

I00-I99 — Diseases of the Circulatory System (I00-I99)

IncludesDiffers
I34.0
  • Nonrheumatic mitral (valve) incompetence NOS
  • Nonrheumatic mitral (valve) regurgitation NOS
I34.81
  • Nonrheumatic mitral (valve) annular calcification
  • Mitral (valve) annulus calcification NOS

No Excludes2, Code first, Use additional code and 7th character note at either code.

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on. In a row that differs, each code’s own notes are listed under it, and the notes every code shares are listed once beneath them.

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Derived from the official CMS ICD-10-CM tabular data (FY2027). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources