2025 ICD-10-CM code I50.3
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Diseases of the circulatory system - Other forms of heart disease Diseases of the circulatory system (I00-I99) Feed
Diastolic (congestive) heart failure; also known as heart failure with preserved ejection fraction (HFpEF).
Medical necessity for treatment of diastolic heart failure is established by the presence of symptoms impacting the patient's quality of life and functional capacity.This can include documentation of shortness of breath, fatigue, edema, and reduced exercise tolerance.Objective evidence from diagnostic testing is also needed to support the diagnosis and to direct appropriate treatment.
The clinical responsibility for this diagnosis includes assessment of symptoms, physical examination, echocardiogram (to assess ejection fraction and diastolic function), electrocardiogram (ECG), and other necessary tests to confirm the diagnosis. Treatment may involve lifestyle modifications, medications, and potentially device therapy.
In simple words: Diastolic heart failure means your heart has trouble relaxing and filling with blood between beats. This can lead to symptoms like shortness of breath and fatigue, even if your heart pumps out a normal amount of blood with each beat. This diagnosis requires further specification about whether the condition is acute (sudden onset), chronic (long-lasting), or both.
Diastolic (congestive) heart failure, also known as heart failure with preserved ejection fraction (HFpEF), is a type of heart failure characterized by impaired relaxation and filling of the left ventricle during diastole (the relaxation phase of the heart cycle). This results in reduced cardiac output and symptoms of heart failure.The condition is often associated with normal or near-normal ejection fraction (the percentage of blood pumped out of the left ventricle with each contraction).This code may also apply to end-stage heart failure, when applicable.Further specification with a fifth digit is required (0-Unspecified, 1-Acute, 2-Chronic, 3-Acute on chronic).
Example 1: A 70-year-old female patient presents with shortness of breath on exertion, fatigue, and lower extremity edema.Echocardiography reveals a preserved ejection fraction but impaired diastolic function.The diagnosis of chronic diastolic heart failure (I50.32) is made., A 65-year-old male patient is admitted to the hospital with acute shortness of breath and pulmonary edema.Echocardiography shows normal ejection fraction but evidence of acute diastolic dysfunction.The diagnosis of acute diastolic heart failure (I50.31) is documented., An 80-year-old patient with a history of hypertension and diabetes presents with worsening dyspnea and fatigue.Cardiac evaluation reveals a preserved ejection fraction and evidence of chronic diastolic dysfunction. They have also experienced an acute exacerbation of their symptoms.The diagnosis of acute on chronic diastolic heart failure (I50.33) is assigned.
Detailed history and physical examination documenting symptoms consistent with heart failure.Echocardiogram report showing preserved ejection fraction and evidence of diastolic dysfunction.Relevant laboratory results including cardiac biomarkers, electrolytes, and renal function tests.Prior medical records documenting history of hypertension, diabetes, or other contributing factors.
** While I50.3 is used to code heart failure with preserved ejection fraction (HFpEF), it's crucial to note that this is a general code.For more precise reimbursement, sub-codes (I50.30-I50.33) should be used to specify the acuity and chronicity of the heart failure.Always consult the most recent coding guidelines and payer-specific rules.
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- Specialties:Cardiology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office