ICD-10 Coding for Congestive Heart Failure with Preserved Ejection Fraction(I50.31, I50.32, I50.33)
Complete ICD-10-CM coding and documentation guide for Congestive Heart Failure with Preserved Ejection Fraction. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Congestive Heart Failure with Preserved Ejection Fraction
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I50.31 | Acute diastolic (congestive) heart failure | Use when acute symptoms of diastolic heart failure are present with EF >50%. |
|
| I50.32 | Chronic diastolic heart failure | Use for chronic diastolic heart failure with EF >50%. |
|
| I50.33 | Acute on chronic diastolic heart failure | Use for acute exacerbations on a background of chronic diastolic heart failure. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for CHFpEF
Essential facts and insights about Congestive Heart Failure with Preserved Ejection Fraction
Primary ICD-10-CM Codes for chfpef
Decision Criteria
clinical Criteria
- Presence of acute heart failure symptoms with EF >50%
Applicable To
- Acute heart failure with preserved ejection fraction
Excludes
- Chronic diastolic heart failure (I50.32)
Clinical Validation Requirements
- Ejection fraction >50%
- Symptoms of acute heart failure such as pulmonary edema
Code-Specific Risks
- Incorrectly coding as chronic if acute symptoms are present
Coding Notes
- Ensure documentation specifies acute diastolic heart failure with EF >50%.
I50.32 - Chronic diastolic heart failure
Use for chronic diastolic heart failure with EF >50%.
Applicable To
- Chronic heart failure with preserved ejection fraction
Excludes
- Acute diastolic heart failure (I50.31)
Clinical Validation Requirements
- Ejection fraction >50%
- Chronic symptoms of heart failure such as fatigue, dyspnea
Coding Notes
Document chronicity and EF >50% clearly.
I50.33 - Acute on chronic diastolic heart failure
Use for acute exacerbations on a background of chronic diastolic heart failure.
Applicable To
- Acute exacerbation of chronic heart failure with preserved ejection fraction
Excludes
- Purely acute or chronic diastolic heart failure
Clinical Validation Requirements
- Ejection fraction >50%
- Combination of acute and chronic heart failure symptoms
Coding Notes
Ensure documentation reflects both acute and chronic aspects.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Congestive Heart Failure with Preserved Ejection Fraction to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I50.31.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with coding standards requiring specificity., Financial: Potential for denied claims due to lack of specificity.
Mitigation Strategy
Always link diastolic dysfunction to heart failure in documentation.
Impact
Reimbursement: May lead to lower reimbursement due to unspecified code I50.9., Compliance: Non-compliance with coding guidelines for specificity., Data Quality: Reduces accuracy of clinical data and outcomes tracking.
Mitigation Strategy
Specify 'diastolic' or 'HFpEF' to avoid unspecified coding.
Impact
Risk of audits due to high use of unspecified codes like I50.9.
Mitigation Strategy
Ensure documentation specifies type and acuity of heart failure.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Congestive Heart Failure with Preserved Ejection Fraction, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Congestive Heart Failure with Preserved Ejection Fraction
Use these documentation templates to ensure complete and accurate documentation for Congestive Heart Failure with Preserved Ejection Fraction. These templates include all required elements for proper coding and billing.
Acute on Chronic HFpEF with Hypertension
Specialty: CardiologyRequired Elements
- EF percentage
- Acuity (acute, chronic, acute on chronic)
- Link to hypertension
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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