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ICD-10 Coding for Systolic Heart Failure(I50.21, I50.22, I50.23)

Complete ICD-10-CM coding and documentation guide for Systolic Heart Failure. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

HFrEFHeart Failure with Reduced Ejection FractionSystolic CHF

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Related ICD-10 Code Ranges

Complete code families applicable to Systolic Heart Failure

I50.2-I50.23Primary Range

ICD-10 codes for systolic heart failure

This range includes all codes specific to systolic heart failure, covering acute, chronic, and acute on chronic conditions.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
I50.21Acute systolic (congestive) heart failureUse when the patient presents with acute symptoms and LVEF ≤40%.
  • LVEF ≤40%
  • Acute symptoms such as dyspnea and pulmonary edema
I50.22Chronic systolic (congestive) heart failureUse for patients with stable chronic symptoms and LVEF ≤40%.
  • LVEF ≤40%
  • Chronic symptoms managed with medication
I50.23Acute on chronic systolic (congestive) heart failureUse when an acute exacerbation occurs in a patient with chronic systolic heart failure.
  • LVEF ≤40%
  • Acute exacerbation on a background of chronic symptoms

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 systolic heart failure

Essential facts and insights about Systolic Heart Failure

The ICD-10 code for systolic heart failure is I50.2-, with specific codes for acute (I50.21), chronic (I50.22), and acute on chronic (I50.23) conditions.

Primary ICD-10-CM Codes for systolic heart failure

I50.21
Acute systolic (congestive) heart failure
Billable Code

Decision Criteria

clinical Criteria

  • Presence of acute heart failure symptoms and LVEF ≤40%

Applicable To

  • Acute heart failure with reduced ejection fraction

Excludes

  • Diastolic heart failure (I50.3-)
  • Combined systolic and diastolic heart failure (I50.4-)

Clinical Validation Requirements

  • LVEF ≤40%
  • Acute symptoms such as dyspnea and pulmonary edema

Code-Specific Risks

  • Risk of incorrect coding if acute symptoms are not documented.

Coding Notes

  • Ensure acute symptoms and reduced EF are documented.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Hypertensive heart disease with heart failure

I11.0
Use as a primary code when hypertension is the underlying cause.

Long-term (current) use of anticoagulants

Z79.01
Use when anticoagulant therapy is part of the treatment plan.

Hypertensive heart and chronic kidney disease with heart failure

I13.0
Use when both hypertension and CKD are present.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Acute diastolic (congestive) heart failure

I50.31
Use when LVEF is preserved and symptoms are acute.

Chronic diastolic (congestive) heart failure

I50.32
Use when LVEF is preserved and symptoms are chronic.

Acute on chronic diastolic (congestive) heart failure

I50.33
Use when LVEF is preserved and both acute and chronic symptoms are present.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Systolic Heart Failure to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I50.21.

Impact

Clinical: Inaccurate treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential for incorrect reimbursement.

Mitigation Strategy

Always include EF in heart failure documentation., Use templates that prompt for EF values.

Impact

Reimbursement: Incorrect DRG assignment may affect payment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient registry data.

Mitigation Strategy

Wait for echocardiogram confirmation of LVEF before coding.

Impact

Audits may target records lacking EF documentation for heart failure codes.

Mitigation Strategy

Implement mandatory EF documentation in EHR templates.

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 Systolic Heart Failure, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Systolic Heart Failure

Use these documentation templates to ensure complete and accurate documentation for Systolic Heart Failure. These templates include all required elements for proper coding and billing.

Chronic management of systolic heart failure

Specialty: Cardiology

Required Elements

  • Type and acuity of heart failure
  • LVEF measurement
  • Chronic management plan

Example Documentation

Chronic systolic CHF (I50.22), LVEF 35%, stable on carvedilol.

Examples: Poor vs. Good Documentation

Poor Documentation Example
CHF stable.
Good Documentation Example
Chronic systolic CHF, LVEF 35%, stable on carvedilol.
Explanation
The good example specifies the type, acuity, and management plan.

Need help with ICD-10 coding for Systolic Heart Failure? Ask your questions below.

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