October 1 update. Our PDGM and ICD-10 tools now use the FY2027 code set: 190 codes added, 30 deleted, and no existing code changed clinical group.

See what changed

ICD-10 · PDGM grouping

I36 Nonrheumatic tricuspid valve disorders

All 5 codes in the I36 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.

ICD-10-CM FY2027 · CMS grouper v07.2.26

Codes in family

5

Can lead a claim

5

Cannot lead a claim

0

What CMS assigns to I36

All 5 codes group to MMTA - Cardiac and Circulatory. 4 of the 5 count toward the Valve Disorders comorbidity subgroup; 1 is assigned none. Every code can lead a claim.

  • Valve Disorders: counts toward the high comorbidity tier only in an interaction pair.

Every code in I36

Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.

CodeDescriptionPrimary positionClinical groupComorbidity subgroup
I36.0Nonrheumatic tricuspid (valve) stenosisCan lead a claimHValve Disorders
I36.1Nonrheumatic tricuspid (valve) insufficiencyCan lead a claimHValve Disorders
I36.2Nonrheumatic tricuspid (valve) stenosis with insufficiencyCan lead a claimHValve Disorders
I36.8Other nonrheumatic tricuspid valve disordersCan lead a claimHValve Disorders
I36.9Nonrheumatic tricuspid valve disorder, unspecifiedCan lead a claimHNone

Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.

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