ICD-10 Code I36.1 – Nonrheumatic tricuspid (valve) insufficiency (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code I36.1 – Nonrheumatic tricuspid (valve) insufficiency
What it is
I36.1 identifies tricuspid valve regurgitation that is not caused by rheumatic heart disease. It means blood leaks backward through the tricuspid valve because the valve does not close properly.
Clinical signs
Clinical features vary; refer to documentation. Common findings may include a tricuspid regurgitation murmur, right-sided heart enlargement, or signs of systemic venous congestion documented on exam or imaging.
When to use this code
Use this code when the record clearly documents nonrheumatic tricuspid insufficiency, tricuspid regurgitation, or tricuspid valve incompetence. It is appropriate when the provider specifies the valve disorder and does not link it to rheumatic disease.
Code it for chronic or newly identified regurgitation confirmed in cardiology notes, echocardiography reports, or discharge summaries. Check documentation if the cause is unclear or if another valve lesion is the primary diagnosis.
Do not use for
Do not use I36.1 for rheumatic tricuspid valve disease or for congenital tricuspid anomalies unless the documentation specifically supports this code. Check documentation when the note only says “heart murmur” or “valvular disease.”
Coding tip
Confirm that “nonrheumatic” and “tricuspid insufficiency/regurgitation” are both supported in the record before assigning I36.1.