ICD-10 Coding for Heart Failure with Preserved Ejection Fraction(I50.31, I50.32, I50.33)
Complete ICD-10-CM coding and documentation guide for 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 Heart Failure with Preserved Ejection Fraction
I50.3xPrimary Range
Heart failure with preserved ejection fraction
This range includes codes for acute, chronic, and acute-on-chronic HFpEF.
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 heart failure | Use when acute decompensation of HFpEF is documented with supporting clinical evidence. |
|
| I50.32 | Chronic diastolic heart failure | Use for patients with stable chronic HFpEF with documented diastolic dysfunction. |
|
| I50.33 | Acute on chronic diastolic heart failure | Use when there is an acute exacerbation of chronic HFpEF with documented evidence. |
|
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 HFpEF
Essential facts and insights about Heart Failure with Preserved Ejection Fraction
Primary ICD-10-CM Codes for hfpef
Decision Criteria
clinical Criteria
- Presence of acute symptoms and echocardiographic evidence of diastolic dysfunction.
Applicable To
- Acute HFpEF
Excludes
- Systolic heart failure
Clinical Validation Requirements
- Paroxysmal nocturnal dyspnea
- Rales
- Echocardiogram showing E/e' ≥14
- BNP >100 pg/mL
Code-Specific Risks
- Incorrectly coding as systolic heart failure
Coding Notes
- Ensure documentation specifies 'acute' and includes clinical findings.
I50.32 - Chronic diastolic heart failure
Use for patients with stable chronic HFpEF with documented diastolic dysfunction.
Applicable To
- Chronic HFpEF
Excludes
- Systolic heart failure
Clinical Validation Requirements
- Stable exertional dyspnea
- Echocardiogram showing LVEF ≥50%
- LA enlargement
Coding Notes
Document LVEF and diastolic parameters clearly.
I50.33 - Acute on chronic diastolic heart failure
Use when there is an acute exacerbation of chronic HFpEF with documented evidence.
Applicable To
- Acute exacerbation of chronic HFpEF
Excludes
- Systolic heart failure
Clinical Validation Requirements
- Worsening symptoms
- Volume overload
- Echocardiogram findings consistent with diastolic dysfunction
Coding Notes
Ensure documentation captures both acute and chronic elements.
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 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 inappropriate treatment decisions., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims due to lack of specificity.
Mitigation Strategy
Educate clinicians on the importance of specifying heart failure type., Implement documentation audits.
Impact
Reimbursement: Potential loss of reimbursement due to lack of specificity., Compliance: Non-compliance with coding guidelines., Data Quality: Decreased accuracy in clinical data reporting.
Mitigation Strategy
Use specific codes I50.31, I50.32, or I50.33 based on clinical documentation.
Impact
Coding HFpEF without documented LVEF can trigger audits.
Mitigation Strategy
Ensure all HFpEF documentation includes LVEF values.
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 Heart Failure with Preserved Ejection Fraction, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Heart Failure with Preserved Ejection Fraction
Use these documentation templates to ensure complete and accurate documentation for Heart Failure with Preserved Ejection Fraction. These templates include all required elements for proper coding and billing.
Chronic HFpEF Management
Specialty: CardiologyRequired Elements
- Chief complaint
- History of present illness
- Physical examination
- Diagnostic tests
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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