Program Operations Manual System (POMS)
TN 32 (08-20)
COMPASSIONATE ALLOWANCES INFORMATION
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MITRAL VALVE ATRESIA
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ALTERNATE NAMES |
Mitral Atresia; MA |
DESCRIPTION
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Mitral Valve Atresia is a rare congenital heart defect in which the mitral valve of the heart does not
develop correctly. The mitral valve normally consists of two leaflets and associated
supporting structures. The job of the mitral valve is to allow passage of oxygenated
blood from the left atrium to the left ventricle during the relaxation phase of the
heart cycle and to keep blood from flowing back from the left ventricle to the left
atrium during the contraction phase of the heart cycle. In mitral valve atresia, there
is severe reduction or no flow of blood across the mitral valve. When atresia occurs,
blood from the left atrium of the heart does not flow to the left ventricle, causing
the left ventricle to become small and underdeveloped. Infants surviving into adulthood
may develop problems with their heart functioning later in life due to worsening of
the condition.
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DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND
ICD-9-CM/ICD-10-CM
CODING
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Diagnostic testing:
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Cardiac catheterization; and
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Cardiac magnetic resonance imaging (MRI).
Physical findings:
Infants with mitral valve atresia have the following signs:
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Difficult or rapid breathing;
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Blue tinted skin, lips, and nail beds (cyanosis); and
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ICD-9: 746.89
ICD-10:
Q23.2
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PROGRESSION
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A diagnosis of mitral valve atresia is usually made shortly after birth. Disease progression
is variable based on the severity of the congenital heart disease and the response
to medication and surgical interventions.
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TREATMENT
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The treatment of mitral valve atresia is based on the severity of the condition. Infants
are usually treated with staged surgical interventions and medications. Adults with
congenital heart conditions should be monitored by a cardiologist to assess the need
for medication and surgery and check for infection throughout their lifetime.
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SUGGESTED PROGRAMMATIC
ASSESSMENT* |
Suggested MER for Evaluation:
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Clinical history and examination that describes the diagnostic features of the impairment;
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Cardiology consultation reports; and
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Suggested Listings for
Evaluation: |
DETERMINATION |
LISTING
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REMARKS |
Meets |
4.06
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104.06
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Equals |
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* Adjudicators may, at their discretion, use the Medical Evidence of Record or the
listings suggested to evaluate the claim. However, the decision to allow or deny the
claim rests with the adjudicator.
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