ICD-10 Coding for Congestive Heart Failure with Diastolic Dysfunction(I50.31, I50.32, I50.33)
Complete ICD-10-CM coding and documentation guide for Congestive Heart Failure with Diastolic Dysfunction. 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 Diastolic Dysfunction
I50.3-I50.33Primary Range
Heart failure with diastolic dysfunction
This range includes codes for acute, chronic, and acute on chronic diastolic heart failure.
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 there is acute onset of diastolic heart failure symptoms. |
|
| I50.32 | Chronic diastolic (congestive) heart failure | Use for chronic management of diastolic heart failure. |
|
| I50.33 | Acute on chronic diastolic (congestive) heart failure | Use when there is an acute exacerbation 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 congestive heart failure with diastolic dysfunction
Essential facts and insights about Congestive Heart Failure with Diastolic Dysfunction
Primary ICD-10-CM Codes for congestive heart failure with diastolic dysfunction
Decision Criteria
clinical Criteria
- Presence of acute symptoms and echocardiographic evidence
Applicable To
- Acute heart failure with preserved ejection fraction
Excludes
- Chronic diastolic heart failure (I50.32)
Clinical Validation Requirements
- Acute dyspnea and orthopnea within 48 hours
- Echocardiogram showing E/e' ratio >14
- Chest X-ray indicating vascular redistribution
Code-Specific Risks
- Misclassification as chronic if acute symptoms are not documented
Coding Notes
- Ensure documentation specifies acute onset and links symptoms to diastolic dysfunction.
I50.32 - Chronic diastolic (congestive) heart failure
Use for chronic management of diastolic heart failure.
Applicable To
- Chronic heart failure with preserved ejection fraction
Excludes
- Acute diastolic heart failure (I50.31)
Clinical Validation Requirements
- NYHA Class II-III symptoms for over 3 months
- Stable diuretic regimen
- Baseline elevated NT-proBNP
Coding Notes
Ensure chronicity is well-documented with ongoing treatment plans.
I50.33 - Acute on chronic diastolic (congestive) heart failure
Use when there is an acute exacerbation of chronic diastolic heart failure.
Applicable To
- Acute exacerbation of chronic diastolic heart failure
Excludes
- Purely acute or chronic diastolic heart failure
Clinical Validation Requirements
- Prior heart failure hospitalization
- 20% increase in BNP from baseline
- Documented fluid overload
Coding Notes
Document both acute and chronic aspects clearly.
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 Diastolic Dysfunction to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I50.31.
Impact
Clinical: Leads to inadequate treatment planning., Regulatory: Increases risk of audit failures., Financial: May result in lower reimbursement rates.
Mitigation Strategy
Always specify type of heart failure, Use echocardiogram results to guide coding
Impact
Reimbursement: Potential underpayment due to incorrect DRG assignment., Compliance: Risk of audit failure due to inaccurate coding., Data Quality: Inaccurate clinical data affecting patient care.
Mitigation Strategy
Ensure documentation specifies acute onset and links symptoms to diastolic dysfunction.
Impact
Failure to differentiate between acute and chronic heart failure can lead to audit issues.
Mitigation Strategy
Ensure detailed documentation of symptoms and diagnostic findings.
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 Diastolic Dysfunction, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Congestive Heart Failure with Diastolic Dysfunction
Use these documentation templates to ensure complete and accurate documentation for Congestive Heart Failure with Diastolic Dysfunction. These templates include all required elements for proper coding and billing.
Acute on Chronic Diastolic Heart Failure
Specialty: CardiologyRequired Elements
- Symptom onset and duration
- Echocardiogram results
- BNP levels
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Congestive Heart Failure with Diastolic Dysfunction? Ask your questions below.