ICD-10 Coding for Heart Failure with Mildly Reduced Ejection Fraction(I50.21)
Complete ICD-10-CM coding and documentation guide for Heart Failure with Mildly Reduced 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 Mildly Reduced Ejection Fraction
I50.2-I50.23Primary Range
Heart failure codes, specifically for systolic heart failure
This range includes codes for systolic heart failure, which is the classification used for HFmrEF.
Key Information: ICD-10 code for HFmrEF
Essential facts and insights about Heart Failure with Mildly Reduced Ejection Fraction
Primary ICD-10-CM Code for hfmref
Decision Criteria
clinical Criteria
- EF between 40-49% with symptoms of heart failure
documentation Criteria
- Explicit mention of HFmrEF or mid-range EF
Applicable To
- Heart failure with mildly reduced ejection fraction
Clinical Validation Requirements
- Echocardiogram showing EF 40-49%
- Symptoms such as dyspnea or fatigue
- Structural heart disease evidence
Code-Specific Risks
- Confusion with HFpEF or HFrEF due to similar symptoms
- Incorrect coding without specific EF documentation
Coding Notes
- Ensure EF percentage is documented and falls within the 40-49% range for accurate coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Heart Failure with Mildly Reduced Ejection Fraction to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I50.21.
Impact
Clinical: May lead to incorrect treatment plans., Regulatory: Non-compliance with coding standards., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Standardize EF documentation in heart failure notes, Educate providers on importance of EF in coding
Impact
Reimbursement: May lead to lower reimbursement if coded as unspecified., Compliance: Non-compliance with coding guidelines for specificity., Data Quality: Decreases the accuracy of clinical data.
Mitigation Strategy
Ensure EF is documented and use I50.21 for HFmrEF.
Impact
Lack of EF documentation can lead to audit flags.
Mitigation Strategy
Implement mandatory EF documentation protocols.
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 Mildly Reduced Ejection Fraction, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Heart Failure with Mildly Reduced Ejection Fraction
Use these documentation templates to ensure complete and accurate documentation for Heart Failure with Mildly Reduced Ejection Fraction. These templates include all required elements for proper coding and billing.
Chronic HFmrEF management
Specialty: CardiologyRequired Elements
- EF percentage
- NYHA classification
- Volume status
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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