2025 ICD-10-CM code I50.22
(Active) Effective Date: N/A Diseases of the circulatory system - Other forms of heart disease IX Diseases of the circulatory system Feed
Chronic systolic (congestive) heart failure.
Medical necessity for I50.22 is established when the patient's clinical condition aligns with the diagnostic criteria for chronic systolic heart failure. This includes demonstrating the characteristic symptoms, physical findings, and reduced ejection fraction indicative of impaired left ventricular function.Documentation should clearly link the diagnosis to the patient's presenting complaints and support the need for medical intervention.
Physicians specializing in cardiology or internal medicine are typically responsible for diagnosing and managing chronic systolic heart failure. This involves evaluating symptoms, conducting diagnostic tests (such as echocardiograms, EKGs, and blood tests), and prescribing medications to improve heart function and manage fluid retention.Patient education and lifestyle recommendations, such as dietary changes and exercise, are also essential aspects of care.
In simple words: This refers to a long-term condition where the heart's main pumping chamber isn't squeezing strongly enough, causing fluid to accumulate in the body.It's a type of heart failure specifically related to the heart's contraction power.
This code signifies a chronic form of heart failure where the heart's left ventricle struggles to pump blood effectively, leading to fluid buildup in the lungs and other parts of the body.It is characterized by reduced ejection fraction, the percentage of blood pumped out of the ventricle with each contraction.
Example 1: A 65-year-old patient presents with increasing shortness of breath, especially when lying down, and swelling in the ankles. An echocardiogram reveals a reduced ejection fraction, confirming the diagnosis of chronic systolic heart failure., A patient with a history of coronary artery disease develops progressive fatigue and difficulty breathing.Further examination reveals an enlarged heart and decreased pumping efficiency, indicating chronic systolic heart failure., A patient with long-standing hypertension experiences worsening shortness of breath and fluid retention.Diagnostic tests and clinical evaluation lead to a diagnosis of chronic systolic heart failure secondary to hypertensive heart disease.
Documentation should include details of symptoms (e.g., shortness of breath, edema), physical exam findings (e.g., rales, jugular venous distension), results of diagnostic tests (e.g., echocardiogram showing reduced ejection fraction), and any underlying conditions contributing to heart failure (e.g., coronary artery disease, hypertension).
** It is important to distinguish between acute and chronic systolic heart failure, as the treatment and prognosis can differ. The presence of any comorbidities, such as chronic kidney disease or diabetes, should also be documented, as these can influence the management plan. If the patient has end-stage heart failure, the code I50.84 should be used instead.
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- Specialties:Cardiology, Internal Medicine
- Place of Service:Inpatient Hospital, Office, Outpatient Hospital, Home Health