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2025 ICD-10-CM code I50.812

Chronic right heart failure, characterized by the right ventricle's inability to effectively pump blood to the lungs, leading to congestion in the body.

Appropriate coding requires specifying the acuity (acute, chronic, acute on chronic) and underlying cause when known.Code I50.812 should only be used for chronic right heart failure without specifying another type of heart failure.

Modifiers may be applicable depending on the circumstances of the encounter and services provided. For instance, modifiers may be used to indicate the place of service or the type of visit.

Medical necessity for the diagnosis and management of chronic right heart failure is established by the presence of clinical symptoms and objective findings (e.g., echocardiographic evidence of right ventricular dysfunction, elevated jugular venous pressure) indicating compromised right ventricular function and the need for medical intervention to improve symptoms and prevent complications.

Diagnosis and management of chronic right heart failure;investigating underlying causes; prescribing appropriate medications (e.g., diuretics, inotropes); monitoring vital signs, fluid status, and organ function; patient education and counseling on lifestyle modifications and medication adherence.

IMPORTANT:This code should be differentiated from I50.810 (Right heart failure, unspecified), I50.811 (Acute right heart failure), I50.813 (Acute on chronic right heart failure), and I50.814 (Right heart failure due to left heart failure). Consider also codes for underlying causes, such as pulmonary hypertension or lung disease.

In simple words: Chronic right heart failure means the right side of your heart isn't pumping blood to your lungs as well as it should.This causes blood to back up, leading to swelling in your body, especially in your legs, abdomen, and liver.It's a long-term condition that needs ongoing medical management.

Chronic right heart failure (I50.812) is a condition where the right ventricle of the heart is unable to pump blood efficiently to the lungs. This leads to a backup of blood, causing congestion in the systemic circulation.Symptoms may include peripheral edema, ascites, hepatomegaly, and jugular venous distention.The condition is classified as chronic, indicating its long-standing nature.It's crucial to differentiate this from acute right heart failure and other types of heart failure (left-sided, biventricular).Underlying causes need to be investigated and addressed.

Example 1: A 70-year-old male with a history of chronic obstructive pulmonary disease (COPD) presents with progressive lower extremity edema, ascites, and shortness of breath.Echocardiogram reveals right ventricular dilation and dysfunction.The diagnosis is chronic right heart failure secondary to COPD., A 65-year-old female with a history of pulmonary hypertension is admitted with worsening fatigue, peripheral edema, and elevated jugular venous pressure.Cardiac catheterization confirms elevated right atrial and ventricular pressures.The diagnosis is chronic right heart failure due to pulmonary hypertension., A 55-year-old male with a history of left-sided heart failure develops signs and symptoms consistent with right heart failure, including elevated jugular venous pressure and hepatomegaly.Echocardiogram shows evidence of right ventricular dysfunction secondary to left heart failure.The diagnosis is chronic right heart failure due to left heart failure.

Detailed history and physical examination focusing on cardiovascular symptoms (e.g., edema, dyspnea, fatigue);results of echocardiogram, cardiac catheterization, or other relevant imaging studies; laboratory findings (e.g., BNP, electrolytes); documentation of any underlying conditions; treatment plan and response to treatment.

** Further specification of the etiology of chronic right heart failure may be necessary for appropriate clinical management and reimbursement.

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