ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 I34.1

Billable / Specific

Nonrheumatic mitral (valve) prolapse

I34
Block
1
Synonyms
430
LCDs
21
Payer Policies
0
Linked CPTs

About ICD-10-CM I34.1

ICD-10-CM code I34.1 represents Nonrheumatic mitral (valve) prolapse. This is a billable/specific code in the Circulatory System chapter (block I34). The 2026 edition of ICD-10-CM I34.1 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under I34.1. Per CMS ICD-10-CM Tabular 2026.

  • Floppy nonrheumatic mitral valve syndrome

Type 1 Excludes

Pure excludes, these codes can never be coded together with I34.1. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • Marfan's syndrome (Q87.4-)

Medicare LCD Coverage for I34.1

Local Coverage Determinations (LCDs) from CMS MACs that list I34.1 as a covered diagnosis.

430 LCDs

Showing top 10 of 430 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93313 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93312 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93318 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93317 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT C8927 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT C8925 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93314 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT C8926 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93316 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93315 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing I34.1.

21 policies

5 Medicare

Billing and Coding: Cardiac Catheterization and Coronary Angiography
Policy ID: ART-52850
Billing and Coding: Transesophageal Echocardiography (TEE)
Policy ID: ART-52868
Billing and Coding: Non-Invasive Cerebrovascular Arterial Studies
Policy ID: ART-52992
Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing
Policy ID: ART-56423
Billing and Coding: Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA)
Policy ID: ART-56451

CPT Codes Commonly Billed with I34.1

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for I34.1

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Convert I34.1 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
I34.1 4240 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 I34.1, Billing FAQ

Is ICD-10 code I34.1 billable? +

Yes, I34.1 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to I34.1? +

ICD-10 I34.1 includes: Floppy nonrheumatic mitral valve syndrome.

What codes are Type 1 Excludes for I34.1? +

Type 1 Excludes (never code together with I34.1): Marfan's syndrome (Q87.4-)

What ICD-9 codes does I34.1 map to? +

Per CMS GEMs, I34.1 maps to ICD-9 codes: 4240. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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