2025 ICD-10-CM code I50.813
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Heart Disease - Other forms of heart disease Diseases of the circulatory system (I00-I99) Feed
Acute on chronic right heart failure.
Not applicable to ICD-10 codes.
Medical necessity is established by the presence of an acute exacerbation of chronic right heart failure, requiring urgent medical intervention. The documentation should clearly demonstrate the worsening of the patient's condition compared to their baseline state, justifying the need for immediate hospitalization, medication adjustments, or other interventions.
The clinical responsibility involves diagnosis, assessment, and management of the acute exacerbation of chronic right heart failure. This might include monitoring vital signs, administering medications (e.g., diuretics, inotropes), adjusting treatment plans based on patient response, and possibly initiating interventions like mechanical circulatory support or other advanced therapies, depending on the severity of the condition.
In simple words: This code describes a sudden worsening of a long-term heart condition affecting the right side of the heart.The patient has had a heart problem for a while, and now it has gotten much worse, requiring immediate medical care.
This code classifies acute decompensation or exacerbation of pre-existing chronic (isolated) right ventricular failure.It encompasses situations where a patient with a history of chronic right heart failure experiences a sudden worsening of their condition, requiring immediate medical attention. The right ventricular failure may or may not be isolated; meaning it may occur independently or secondary to left ventricular failure.This code should be used when the acute event is superimposed on a chronic condition.
Example 1: A 70-year-old male patient with a known history of chronic right heart failure presents to the emergency department with shortness of breath, lower extremity edema, and jugular venous distention.His condition has significantly worsened compared to his baseline, necessitating hospitalization and intensive treatment. I50.813 is appropriate., A 65-year-old female with chronic obstructive pulmonary disease and long-standing right heart failure is admitted to the hospital with increased dyspnea, tachypnea, and reduced oxygen saturation.While her underlying COPD exacerbates her heart condition, she demonstrates a clear acute decompensation of her right heart failure. I50.813 is the correct choice., An 82-year-old patient with a history of chronic right ventricular failure experiences a sudden onset of severe chest pain, hypotension, and decreased level of consciousness.This represents an acute decompensation requiring urgent intervention. The physician diagnoses acute on chronic right heart failure with cardiogenic shock.I50.813 is used, and additional codes for the shock and any associated complications would be necessary.
** Accurate coding requires thorough documentation of the patient's clinical presentation, including the presence of both the chronic and acute components of the condition.Consult with your coding specialist if there are any ambiguities in coding the acute-on-chronic right heart failure.
- Revenue Code: Revenue codes will vary depending on the specific services provided and the payer. Consult your payer's guidelines for appropriate revenue codes.
- RVU: RVUs are not directly associated with ICD-10 codes.Reimbursement is determined by the procedures and services rendered, and is dependent on payer contracts and local payment systems.
- Global Days: Not applicable to ICD-10 codes. Global periods are associated with surgical procedures coded with CPT codes.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Fee Schedule: Not applicable to ICD-10 codes.
- Specialties:Cardiology, Internal Medicine, Pulmonary Medicine, Critical Care Medicine
- Place of Service:Inpatient Hospital, Emergency Room - Hospital,Outpatient Hospital,Other Place of Service (depending on the setting of care)