2025 ICD-10-CM code I50.81
Right heart failure, also known as right ventricular failure.
The medical necessity for treatment of right heart failure is established by the presence of signs and symptoms, such as shortness of breath, peripheral edema, and fatigue, that are impacting the patient's quality of life and/or posing a threat to their health.Diagnostic testing, such as echocardiography, may be necessary to confirm the diagnosis and assess the severity of the condition. The medical necessity of specific treatments will depend on the underlying cause of the right heart failure and the patient's overall health status.
Diagnosing and managing right heart failure typically falls under the responsibility of cardiologists, internists, or hospitalists. They are responsible for ordering appropriate tests, prescribing medications, and recommending lifestyle modifications.
- Chapter 9: Diseases of the circulatory system (I00-I99)
- I50.8 Other heart failureI50.81 Right heart failureI50.810 Right heart failure, unspecifiedI50.811 Acute right heart failureI50.812 Chronic right heart failureI50.813 Acute on chronic right heart failure
In simple words: Right heart failure is a condition where the right side of your heart isn't pumping blood as well as it should. This can cause fluid to build up in your body, especially in your legs and ankles.
Right heart failure is a condition where the right side of the heart is unable to pump blood effectively. This can lead to a buildup of fluid in the body, especially in the legs, ankles, and abdomen.
Example 1: A patient presents with shortness of breath, swelling in the legs and ankles, and fatigue. After examination and testing, including an echocardiogram, the physician diagnoses the patient with right heart failure., A patient with a history of chronic obstructive pulmonary disease (COPD) develops worsening shortness of breath and leg swelling.The physician diagnoses the patient with right heart failure secondary to cor pulmonale (right heart failure caused by lung disease)., A patient with a history of left heart failure presents with increased shortness of breath and abdominal swelling. Further testing reveals that the patient has now developed right heart failure in addition to their pre-existing left heart failure.
Documentation should include symptoms, physical exam findings, imaging study results (such as echocardiogram, chest x-ray), and any other relevant test results that support the diagnosis of right heart failure.The underlying cause of right heart failure should also be documented if known.For example, if the right heart failure is due to COPD or left heart failure, this should be noted in the documentation.
** Right heart failure can be acute, chronic, or acute on chronic. More specific codes are available for these distinctions (I50.811, I50.812, I50.813). If the type of right heart failure is not specified, use code I50.810.Also, it’s crucial to distinguish between right heart failure, left heart failure (I50.1), and biventricular heart failure (I50.82) for accurate coding and treatment.
- Payment Status: Active
- Specialties:Cardiology, Internal Medicine, Hospital Medicine, Pulmonary Medicine
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office,Emergency Room - Hospital