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

ICD-10 I36.0

Billable / Specific

Nonrheumatic tricuspid (valve) stenosis

I36
Block
0
Synonyms
388
LCDs
18
Payer Policies
1
Linked CPTs

About ICD-10-CM I36.0

ICD-10-CM code I36.0 represents Nonrheumatic tricuspid (valve) stenosis. This is a billable/specific code in the Circulatory System chapter (block I36). The 2026 edition of ICD-10-CM I36.0 became effective on October 1, 2025.

Medicare LCD Coverage for I36.0

Local Coverage Determinations (LCDs) from CMS MACs that list I36.0 as a covered diagnosis.

388 LCDs

Showing top 10 of 388 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 I36.0.

18 policies

1 Aetna

Color-Flow Doppler Echocardiography and Myocardial Strain Imaging - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0008

2 Cigna

Plasma Brain Natriuretic Peptide in the Outpatient Setting - (0028)
Policy ID: MM_0028
Transthoracic Echocardiography in Adults - (0510)
Policy ID: MM_0510

5 Medicare

Billing and Coding: Cardiac Catheterization and Coronary Angiography
Policy ID: ART-52850
Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing
Policy ID: ART-56423
Billing and Coding: Cardiac Radionuclide Imaging
Policy ID: ART-56476
Billing and Coding: Cardiac Catheterization and Coronary Angiography
Policy ID: ART-56500
Billing and Coding: Transesophageal Echocardiography (TEE)
Policy ID: ART-56505

CPT Codes Commonly Billed with I36.0

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

1 linkages
  • 93306 Echo with Doppler — heart failure, cardiomyopathy, mitral/aortic/tricuspid valve disease, chest pain, dyspnea, CAD, pulmonary HTN, ASD, VSD, congenital valve Cardiology

Convert I36.0 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
I36.0 4242 10000

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

ICD-10 I36.0, Billing FAQ

Is ICD-10 code I36.0 billable? +

Yes, I36.0 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What CPT codes are commonly billed with I36.0? +

Procedures frequently paired with I36.0 include: 93306.

What ICD-9 codes does I36.0 map to? +

Per CMS GEMs, I36.0 maps to ICD-9 codes: 4242. 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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