I36.1
Nonrheumatic tricuspid (valve) insufficiency
I36.1 (also written I361) is a billable ICD-10-CM diagnosis code for nonrheumatic tricuspid (valve) insufficiency. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 5 codes in category I36 (Nonrheumatic tricuspid valve disorders). The Alphabetic Index lists it under 1 entry. Its coding notes include 4 Excludes1 entries and 10 Excludes2 entries.
Excludes1
Not coded here. The listed conditions generally should not be reported together.
Excludes2
Not included here. Both codes may be reported if the patient has both conditions.
Also from chapter/block level (10 notes)
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
- systemic connective tissue disorders (M30-M36)
- transient cerebral ischemic attacks and related syndromes (G45.-)
Care settings
How CMS programs treat this code. These are CMS claim edits and list entries, not coverage or eligibility rules.
Home Health Primary
Accepted as the primary (principal) diagnosis on a home health claim. The Home Health Grouper assigns it to the MMTA - Cardiac and Circulatory clinical group.
Source: CMS Home Health Grouper Software v07.2.26, effective October 1, 2026Inclusion terms
Conditions classified to this code.
- Nonrheumatic tricuspid (valve) incompetence
- Nonrheumatic tricuspid (valve) regurgitation
Alphabetic Index terms
Terms the official Alphabetic Index lists for this code. 1 entry