Coding Clinic CHF and Dysfunction RE: 6485343
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Systolic dysfunction with congestive heart failure
Coding Clinic, First Quarter 2009 Page: 8 Effective with discharges: March 27, 2009
Question:
The patient is documented as having systolic dysfunction with acute exacerbation of congestive heart failure (CHF). Can this be coded as acute systolic heart failure with congestive heart failure?
Answer:
Assign code 428.0, Congestive heart failure, unspecified and code 428.23, Systolic heart failure, Acute on chronic. Acute exacerbation of a chronic condition (heart failure) is coded as acute on chronic.
ICD-9-CM's Alphabetic Index provides the following direction for systolic dysfunction with heart failure:
Dysfunction
systolic 429.9
with heart failure -- see
Failure, heart
Additionally, congestive heart failure is not an inherent component of systolic or diastolic heart failure. When the diagnostic statement lists congestive heart failure along with either systolic or diastolic heart failure, two codes are required to report the specific type of heart failure: congestive, diastolic, and/or systolic. This advice is consistent with that published in Coding Clinic, Fourth Quarter 2002, pages 52-53 and Fourth Quarter 2004, page 140.
Sharon Salinas, CCS
Extension 3336
Systolic dysfunction with congestive heart failure
Coding Clinic, First Quarter 2009 Page: 8 Effective with discharges: March 27, 2009
Question:
The patient is documented as having systolic dysfunction with acute exacerbation of congestive heart failure (CHF). Can this be coded as acute systolic heart failure with congestive heart failure?
Answer:
Assign code 428.0, Congestive heart failure, unspecified and code 428.23, Systolic heart failure, Acute on chronic. Acute exacerbation of a chronic condition (heart failure) is coded as acute on chronic.
ICD-9-CM's Alphabetic Index provides the following direction for systolic dysfunction with heart failure:
Dysfunction
systolic 429.9
with heart failure -- see
Failure, heart
Additionally, congestive heart failure is not an inherent component of systolic or diastolic heart failure. When the diagnostic statement lists congestive heart failure along with either systolic or diastolic heart failure, two codes are required to report the specific type of heart failure: congestive, diastolic, and/or systolic. This advice is consistent with that published in Coding Clinic, Fourth Quarter 2002, pages 52-53 and Fourth Quarter 2004, page 140.
Sharon Salinas, CCS
Extension 3336