New Codes for Heart Failure

Other Heart Failure Coding

For FY2018 there is a new subcategory I50.8-. This subcategory was created and new codes were developed to identify and report the several different and specific types of heart failure. This will allow differentiating cases of pure right heart failure from left heart failure. The treatment of the two heart failures (left/right) are different as are the causes.

What is right heart failure?

This type of heart failure occurs because the heart is not pumping blood to the lungs like it should. The right ventricle loses the ability to pump normally and the blood then backs up in other areas of the body, producing congestion. This congestion affects the liver, GI tract, and the extremities.

Common causes of right heart failure:

• Left-sided heart failure
• Lung disease
• Congenital heart disease
• Pulmonary Embolism
• Valvular heart disease
• Pulmonary hypertension

New Codes and Descriptions:

I50.810

Right heart failure, unspecified (right heart failure without mention of left heart failure or right ventricular failure)

I50.811

Acute right heart failure (acute isolated right heart failure or acute (isolated) right ventricular failure)

I50.812

Chronic right heart failure (chronic isolated right heart failure or chronic (isolated) right ventricular failure)

I50.813

Acute on chronic right heart failure (acute on chronic isolated right heart failure, acute on chronic (isolated) right ventricular failure, acute decompensation of chronic (isolated) right ventricular failure or acute exacerbation of chronic (isolated) right ventricular failure

I50.814

Right heart failure due to left heart failure (right ventricular failure secondary to left ventricular failure)

I50.82

Biventricular heart failure

I50.83

High output heart failure

I50.84

End-stage heart failure (stage D heart failure)

I50.89

Other heart failure

See the ICD-10-CM Alphabetic Index and Tabular for instructional notes. There are “code also” notes and “Excludes1” notes for some of these new codes.

Treatment for heart failure:

Oftentimes, the underlying condition/cause can be treated and help improve/correct heart failure. An example would be repairing a heart valve which may reverse the heart failure. Most times, patients do require lifelong medication. Medications may include ACE inhibitors, angiotensin II receptor blockers, beta blockers, aldosterone antagonists, and diuretics. Other medications may also be used but these are the most common.

Prevention:

• Reduce salty food
• Do not smoke or stop smoking
• Reduce/stop alcohol use
• Control of other medical conditions such as HTN and DM
• Be physically active when possible
• Eat healthy foods
• Maintain a healthy weight
• Have less stress
• Monitor high blood sugar level and ketone levels in your urine

Authored by Kim Boy, RHIT, CDIP, CCS, CCS-P

References:

ICD-10-CM Alphabetic Index and Tabular

AHA Coding Clinic, Fourth Quarter 2017 Page: 15-16

www.nytimes.com/health/guides/disease/right-sided-heart-failure/overview.html
https://www.mayoclinic.org/diseases-conditions/heart-failure/basics/prevention/con-20029801

The information contained in this coding advice is valid at the time of posting. Viewers are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.