Health Information Management

Tip: Reporting heart failure in ICD-10-CM

APCs Insider, October 2, 2015

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Codes for heart failure are located in ICD-10-CM category I50. Coders should note the list of conditions to code first with diagnoses in this category. The codes are classified by time and temporal factors.
Coders have options to report systolic (I50.2-), diastolic (I50.3-), and combined (I50.4-) heart failure.
 
Systolic pressure is a measurement of the maximum push of blood being forced into an artery from the ventricle during a cardiac contraction. Systolic heart failure occurs when the left ventricle cannot contract normally to circulate enough blood.
 
Diastolic pressure measures the pressure of the blood left in the arteries between ventricular contractions. Diastolic heart failure occurs when the left ventricle cannot relax normally to allow the heart to fill with enough blood between beats.
 
ICD-10-CM codes for heart failure are further classified as:
  • Acute (fifth digit 1)
  • Chronic (fifth digit 2)
  • Acute on chronic (fifth digit 3)
Coders will need to look for these terms in the documentation.
 
This tip is adapted from “Prepare for ICD-10-CM implementation by reviewing common cardiac conditions" in the October issue of Briefings on APCs.



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