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Home/Diagnosis/ICD-10 Coding for Pulmonary Congestion

ICD-10 Coding for Pulmonary Congestion

I50.0
J81.0

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

Also Known as:
Pulmonary Edema
Lung Congestion
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Key Information: ICD-10 Coding for Pulmonary Congestion

Essential facts and insights about ICD-10 Coding for Pulmonary Congestion

Use ICD-10 code I50.0 for congestive heart failure, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Congestive heart failure

Non-Billable
I50.0
Non-Billable

Diagnostic Criteria

  • • Presence of heart failure symptoms and diagnostic confirmation.

Applicable To

  • • Acute heart failure
  • • Chronic heart failure

Important Notes

  • • Do not code both I50.0 and J81.0 if edema is due to heart failure.

Acute pulmonary edema

Billable Code
J81.0
Billable

Diagnostic Criteria

  • • CXR showing bilateral infiltrates
  • • PaO2/FiO2 ratio <300

Applicable To

  • • Pulmonary congestion

Important Notes

  • • Ensure documentation specifies non-cardiogenic cause if using J81.0.
Ancillary Codes

Additional codes that may be used with this diagnosis

J96.01

Acute respiratory failure with hypoxia

Use when respiratory failure is present with pulmonary congestion.

R09.02

Hypoxemia

Use when hypoxemia is documented and treated separately.

Frequently Asked Questions

What is the ICD-10 code for pulmonary congestion?

The ICD-10 code for pulmonary congestion due to heart failure is I50.0. For non-cardiogenic causes, use J81.0.

How do you code pulmonary edema with CHF?

When pulmonary edema is due to CHF, code only the CHF using I50.0, as per coding guidelines.

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