ICD-10 Coding for Diastolic Congestive Heart Failure(I50.31, I50.32)
Complete ICD-10-CM coding and documentation guide for Diastolic Congestive Heart Failure. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Diastolic Congestive Heart Failure
I50.3-Primary Range
Heart failure with diastolic dysfunction
This range includes codes for diastolic heart failure, specifying acuity such as acute, chronic, or acute on chronic.
Hypertensive heart disease with heart failure
Used when hypertension is the cause of heart failure, sequenced before heart failure codes.
Chronic kidney disease
Used when chronic kidney disease is present with hypertensive heart disease.
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 diastolic heart failure is documented with supporting clinical evidence. |
|
| I50.32 | Chronic diastolic heart failure | Use when chronic diastolic heart failure is documented with supporting clinical 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 acute diastolic congestive heart failure
Essential facts and insights about Diastolic Congestive Heart Failure
Primary ICD-10-CM Codes for diastolic congestive heart failure
Decision Criteria
clinical Criteria
- Ejection fraction >50% with acute symptoms
documentation Criteria
- Explicit mention of 'acute diastolic heart failure'
Applicable To
- Acute heart failure with preserved ejection fraction
Excludes
- Systolic heart failure (I50.2-)
Clinical Validation Requirements
- Ejection fraction >50%
- Acute symptoms such as orthopnea or paroxysmal nocturnal dyspnea
- BNP >400 pg/mL
Code-Specific Risks
- Misclassification if ejection fraction is not documented.
Coding Notes
- Ensure documentation specifies 'diastolic' and includes ejection fraction.
I50.32 - Chronic diastolic heart failure
Use when chronic diastolic heart failure is documented with supporting clinical evidence.
Applicable To
- Chronic heart failure with preserved ejection fraction
Excludes
- Systolic heart failure (I50.2-)
Clinical Validation Requirements
- Ejection fraction >50%
- Chronic symptoms managed with diuretics
- LV hypertrophy on echocardiogram
Coding Notes
Ensure documentation specifies 'chronic diastolic' and includes ejection fraction.
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 Diastolic Congestive Heart Failure to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I50.31.
Impact
Clinical: Inaccurate treatment plans., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Educate providers on documentation requirements.
Impact
Reimbursement: Lower reimbursement due to unspecified codes., Compliance: Non-compliance with coding guidelines., Data Quality: Poor data quality affecting clinical outcomes.
Mitigation Strategy
Ensure documentation specifies diastolic heart failure and acuity.
Impact
Risk of audits due to unspecified heart failure codes.
Mitigation Strategy
Ensure detailed documentation specifying heart failure type and acuity.
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 Diastolic Congestive Heart Failure, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Diastolic Congestive Heart Failure
Use these documentation templates to ensure complete and accurate documentation for Diastolic Congestive Heart Failure. These templates include all required elements for proper coding and billing.
Acute on chronic diastolic heart failure
Specialty: CardiologyRequired Elements
- Ejection fraction
- Symptoms
- Response to treatment
- Specific mention of diastolic CHF
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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