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Home/Diagnosis/ICD-10 Coding for Congestive Heart Failure

ICD-10 Coding for Congestive Heart Failure

I50.21
I11.0

Complete ICD-10-CM coding and documentation guide for icd-10 coding for congestive heart failure includes clinical validation requirements, medical necessity guidelines, and coding policies.

Also Known as:
CHF
Heart Failure
Cardiac Failure
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Key Information: ICD-10 Coding for Congestive Heart Failure

Essential facts and insights about ICD-10 Coding for Congestive Heart Failure

Use ICD-10 code I50.21 for acute systolic (congestive) heart failure, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Acute systolic (congestive) heart failure

Billable Code
I50.21
Billable

Diagnostic Criteria

  • • Ejection fraction <40%
  • • Pulmonary edema on chest X-ray
  • • BNP >500 pg/mL

Applicable To

  • • Acute left ventricular failure

Important Notes

  • • Ensure documentation specifies 'acute' and 'systolic' to avoid unspecified coding.

Hypertensive heart disease with heart failure

Billable Code
I11.0
Billable

Diagnostic Criteria

  • • Documented hypertension with heart failure symptoms
  • • Linkage between hypertension and heart failure in documentation

Applicable To

  • • Heart failure due to hypertension

Important Notes

  • • Ensure the documentation clearly states the relationship between hypertension and heart failure.
Ancillary Codes

Additional codes that may be used with this diagnosis

N18.4

Chronic kidney disease, stage 4

Use when chronic kidney disease is present alongside heart failure.

I10

Essential (primary) hypertension

Use when hypertension is present without heart failure.

Frequently Asked Questions

What is the ICD-10 code for congestive heart failure?

The ICD-10 code for congestive heart failure varies by type and acuity, such as I50.21 for acute systolic heart failure.

How do you code heart failure with hypertension?

Use I11.0 for hypertensive heart disease with heart failure, and specify the type of heart failure with an additional I50 code.

What documentation is needed for CHF coding?

Documentation must specify the type and acuity of heart failure, such as 'acute systolic' with supporting clinical evidence.

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