Coding Tip: New Codes for Heart Failure in FY2018

by | Dec 4, 2017 | Coding Tips, Education, ICD-10 | 0 comments

Kim Carrier RHIT, CDIP, CCS, CCS-P Director of Coding Quality Assurance AHIMA Approved ICD-10-CM/PCS Trainer

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

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

Happy Coding!

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.

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