2025 ICD-10-CM code I50.2
Systolic (congestive) heart failure, also known as heart failure with reduced ejection fraction (HFrEF).This condition involves the heart's inability to pump blood effectively.
Medical necessity for treatment of systolic heart failure is established by the presence of characteristic symptoms, physical findings, and diagnostic test results that confirm the diagnosis and indicate the need for intervention to improve cardiac function and reduce symptoms.
Diagnosing and managing systolic heart failure involves a multidisciplinary approach, often led by cardiologists, internists, or family physicians.Responsibilities include evaluating patient symptoms, conducting physical exams, ordering diagnostic tests (such as echocardiograms, EKGs, and blood tests), and prescribing appropriate medications and lifestyle modifications.
In simple words: Systolic heart failure is a condition where the heart's main pumping chamber is weakened and cannot pump out enough blood with each beat. This can lead to fluid buildup in the lungs and body, causing shortness of breath and swelling.
Systolic (congestive) heart failure is a condition where the heart's left ventricle cannot pump blood efficiently, resulting in a reduced ejection fraction. The heart is unable to pump with enough force to meet the body's demands for oxygen-rich blood. This can lead to fluid buildup in the lungs and other parts of the body.If applicable, code also end stage heart failure (I50.84).
Example 1: A 65-year-old male presents with shortness of breath, fatigue, and swelling in his ankles. An echocardiogram reveals a reduced ejection fraction, confirming systolic heart failure., A 70-year-old female with a history of coronary artery disease experiences worsening shortness of breath and fatigue. Diagnostic testing confirms systolic heart failure as the cause., A 55-year-old male with long-standing hypertension develops symptoms of systolic heart failure, including shortness of breath and difficulty lying flat.
Documentation should include the patient's symptoms, physical exam findings, results of diagnostic tests (such as echocardiogram, EKG, and blood tests), and the physician's assessment of the severity and etiology of the heart failure.
** Excludes1: combined systolic (congestive) and diastolic (congestive) heart failure (I50.4). Excludes2: cardiac arrest (I46.-), neonatal cardiac failure (P29.0). Code first heart failure complicating abortion or ectopic or molar pregnancy (O00-O07, O08.8), heart failure due to hypertension (I11.0), heart failure due to hypertension with chronic kidney disease (I13.-), heart failure following surgery (I97.13-), obstetric surgery and procedures (O75.4), rheumatic heart failure (I09.81).
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