ICD-10 Clinical Concepts for Cardiology
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Resource Cardiology heart
- Thread starter Lori
- Start date
Lori
Well-known member
Moda Cardiology, Radiology, and Ultrasound CPT Code List
WhitneyH_24046
Well-known member
Thanks Lori!
Lori
Well-known member
Depends on your documentation which code is appropriate.
Right-sided or right ventricular (RV) heart failure usually occurs as a result of left-sided failure.
Right-sided heart failure is coded in ICD-10-CM to the default code I50.9 heart failure, unspecified. This code is not affected by documentation of the acuity of the condition.
Before we can code heart failure, though, we need to review the medical record to determine the underlying cause. I would suggest querying the physician regarding whether the “right-heart failure” is due to an underlying pulmonary process or right failure related to left-sided failure (CHF—systolic versus diastolic).
With left-sided heart failure or left ventricular (LV) heart failure, you may have either systolic and/or diastolic heart failure. Diastolic failure occurs when the muscle becomes stiff and loses its ability to relax normally. Documentation of heart failure with preserved EF(HFpEF), heart failure with preserved systolic function is also called “diastolic HF” or “diastolic dysfunction.” Documentation of “HF with reduced EF(HFrEF), HF with low EF, with reduced systolic function” or other similar terms also called “systolic HF.” The ventricle loses its ability to contract normally.
These terms can be used to clarify the type of heart failure for code assignment. Systolic (congestive) heart failure being coded to I50.2; with Diastolic (congestive) heart failure coded to I50.3 and I50.4 for combined systolic/diastolic heart failure in ICD-10-CM.
Q&A: Reporting right-sided heart | ACDIS
Q: If you have an acute exacerbation of a chronic right heart failure (CHF) with a preserved ejection fraction (EF)— above 55%—can you code it as hear
acdis.org
Types of Heart Failure
Heart failure can affect the heart’s left, right, or both sides and it can be acute, chronic, or acute-on-chronic.
• Left-sided heart failure, or left ventricular (LV) heart failure – failure of the left ventricle, the main pumping
chamber of the heart, to pump blood out to the body effectively. Accumulation of excess fluid behind the left
ventricle causes dyspnea, orthopnea, paroxysmal nocturnal dyspnea, and/or acute pulmonary edema. There
are two different types of left-sided heart failure which call for different treatment approaches:
Systolic heart failure, aka heart failure with reduced ejection fraction (HFrEF) – the left ventricle loses
its ability to contract normally. The heart can’t pump with enough force to push enough blood into
circulation.
Diastolic heart failure, aka heart failure with preserved ejection fraction (HFpEF) – the left ventricle
loses its ability to relax normally because the muscle has become stiff. The heart can’t fill properly with
blood during the resting period between each beat.
• Right-sided heart failure, or right ventricular (RV) heart failure – failure of the right ventricle to move blood
returning from systemic circulation into the lungs. Blood backs up in the body’s veins, causing systemic
venous congestion (distended neck veins), pitting edema of the lower extremities or other dependent
portions of the body, enlarged tender liver, and/or ascites.
• Acute heart failure develops suddenly and symptoms are initially severe. With proper diagnosis and
treatment, it may improve rapidly and last for only a short period.
• Chronic heart failure develops slowly and the onset of symptoms may be gradual. Treatment is aimed at
managing the underlying cause, minimizing symptoms, and preventing heart failure from becoming worse.
• Acute on chronic heart failure occurs when there is an acute decompensation of chronic heart failure.
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