Congestive Heart Failure (ICD-10 – I50.9 – Heart Failure Unspecified), means that the heart’s pumping power is weaker than normal; it doesn’t mean that the heart has stopped working. “Congestive Heart Failure (CHF) develops when plasma volume increases and fluid accumulates in the lungs abdominal organs, the liver and peripheral tissues.”1

Causes of Heart Failure

Heart failure is caused by many conditions that damage the heart muscle, including the following:

  • Coronary artery disease
  • Heart attack
  • Cardiomyopathy, and
  • Conditions that overwork the heart (high blood pressure, valve disease, thyroid disease, kidney disease and diabetes.
Symptoms of Heart Failure

Symptoms of heart failure can be silent or from mild to severe and can include:

  • Congested lungs, fluid in the lungs which could lead to shortness of breath or difficulty breathing and can include cough or wheezing
  • Water retention, which could mean less blood to the kidneys, increased swelling to the lower extremities
  • Dizziness and maybe weakness, and
  • Irregular heartbeats

The treatment considered for CHF today has come a long way. A really strong control on medications and lifestyle along with careful monitoring are important steps. Based on physician’s findings, more advanced treatment options for heart failure are now available.

CHF is number 32 in the top 100 list of diagnosis codes identified in the emergency medicine diagnosis coding performed at McKesson. Heart failure, unspecified (I50.9) in the ICD-10 book includes:

  • Biventricular (heart) failure NOS
  • Cardiac, heart or myocardial failure NOS
  • Congestive heart disease
  • Congestive heart failure NOS
  • Right ventricular failure (secondary to left heart failure)
  • EXCLUDES: fluid overload (E87.70)
Diagnosis Coding

Figure 1 7-17-16

It is imperative that the provider document exactly what the medical history, examination and the diagnostic studies’ findings are, if any, to determine the exact course of action for the condition presented or defined after study. This will also allow the coding staff to select the most appropriate ICD-10 diagnosis code for reporting on the claim for reimbursement. 

References:

  • ICD-10-CM, 2016 Complete Official Code Set, Chapter 9, Page 616, Diseases of the Circulatory System (I00 – I99), AAPC, Optum360 2015
  • Merck Manual, Section 16 – Cardiovascular Disorders, Chapter 203 – Heart Failure, Pages 1682 - 1704, Editor – Keryn A. G. Lane, Publisher – Gary Zelko, June 1999
  • WebMD click here for article on Heart Failure

1Merck Manual, Section 16 – Cardiovascular Disorders, Chapter 203 – Heart Failure, Page 1682, Editor – Keryn A. G. Lane, Publisher – Gary Zelko, June 1999

Author - Male

About the author

Robert Bunting, CPC, CPC-H, CHC, CEDC, CEMC, CAC is Compliance Director – Emergency Medicine, McKesson Business Performance Services.