2025 ICD-10-CM code I50.1
(Active) Effective Date: N/A Revision Date: N/A Diseases of the circulatory system - Other forms of heart disease Diseases of the circulatory system (I00-I99) Feed
Left ventricular failure, unspecified. This code is used when the specific type of heart failure (systolic or diastolic) is unknown.
Modifiers may be applicable depending on the circumstances of the encounter and the services performed.Consult local and payer-specific guidelines for applicable modifiers.
Medical necessity is established based on clinical findings demonstrating impaired left ventricular function.This is supported by symptoms, physical examination findings, and diagnostic testing, including echocardiography which assesses ventricular function and identifies the underlying cause or contributing factors for heart failure.
The clinical responsibility involves a thorough cardiovascular examination, including history taking, physical examination (assessing for edema, jugular venous distention, lung sounds), and diagnostic testing (echocardiography, chest X-ray, blood tests) to determine the extent and nature of the left ventricular dysfunction and the underlying causes.Management may involve medications (diuretics, ACE inhibitors, beta-blockers), lifestyle modifications, and referral for advanced therapies such as cardiac resynchronization therapy (CRT) or implantable cardioverter-defibrillators (ICDs) as appropriate.
In simple words: This code means the patient has a problem with the left side of their heart, specifically the main pumping chamber, and the doctor doesn't know yet if it's a problem with the pumping force or the filling of the chamber.The patient may experience symptoms like shortness of breath or swelling.
I50.1, Left ventricular failure, unspecified, is an ICD-10-CM code indicating left ventricular failure where the specific type (systolic or diastolic) is not specified or cannot be determined.It encompasses instances of heart failure affecting the left ventricle without further clinical specification.The diagnosis requires clinical evaluation to confirm impaired ability of the left ventricle to pump blood effectively, leading to symptoms such as shortness of breath, fatigue, and edema.
Example 1: A 70-year-old male presents with shortness of breath on exertion and lower extremity edema.Echocardiography reveals reduced ejection fraction, but further assessment is needed to clarify whether the primary issue is systolic or diastolic dysfunction.I50.1 is assigned pending further testing., A 65-year-old female admitted to the hospital for acute decompensated heart failure. Initial assessment reveals signs of left ventricular failure but insufficient data to distinguish systolic from diastolic failure. I50.1 is temporarily used, with I50.2x or I50.3x to be applied as further clinical data is obtained., A 55-year-old patient with known heart disease is seen in the outpatient clinic with worsening symptoms of fatigue and shortness of breath, but the type of heart failure (systolic or diastolic) is not determined definitively based on initial testing. I50.1 is coded to reflect the current clinical uncertainty.
Thorough history and physical examination documenting symptoms (dyspnea, orthopnea, paroxysmal nocturnal dyspnea, edema), echocardiogram report with ejection fraction, relevant lab results (BNP, electrolytes, renal function), and any underlying contributing conditions (e.g., hypertension, coronary artery disease).
** This code is used when the diagnosis of left ventricular failure is confirmed, but insufficient clinical information is available to specify whether it's systolic or diastolic. Always strive to use the most precise code possible based on available documentation.The use of I50.1 should be considered temporary if further investigation is ongoing to determine the exact subtype of heart failure.
- Payment Status: Active
- Specialties:Cardiology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office