Heart failure is defined as impairment of diastolic filling or of systolic ejection of blood that results from functional or structural abnormalities of the heart. Systolic (EF below normal <55%) and diastolic with normal or elevated EF (Normal EF 55-70% and elevated >70%).
Signs and Symptoms of CHF:
- Shortness of breath
- Persistent coughing or wheezing
- Build-up of excess fluid in body tissue
- Tiredness, fatigue
- Lack of appetite
- Confusion, impaired thinking
- Increased heart rate
- Indicators of acute heart failure
- Exacerbation of symptoms
- IV medications (usually Lasix)
- Supplemental oxygen
- Pulmonary edema/congestion or increasing (or new) pleural effusion on chest x-ray
- BNP>500 or ProBNP >3,000 (if no renal impairment)
For ICD-10 coding of Heart Failure, the following can be used to document the different types:
- Preserved ejection fraction (HFpEF) – also referred to as diastolic heart failure.
- Reduced ejection fraction (HFrEF) – also referred to as systolic heart failure.
- Preserved/reduced (HFpEF, HFrEF) – also referred to as combinations of both.
Please note that the acuity still needs to be documented.
Example: Patient presented with SOB, LE edema with diagnosis of acute CHF, echo revealed a reduced ejection fraction of 35%. This will be coded as cuite systolic CHF.