Acute on chronic right-sided CHF

Patient with CKD stage 3, admitted with CHF exacerbation.  ECHO shows intact LV size and systolic performance.  EF of 60%.  Biatrial dilatation, with mild dilatation of the RV.  Moderate pulmonary hypertension.  Cardiologist documented that the patient has poor renal function which has been aggravated by the reduced perfusion caused by the right heart failure.  I queried to clarify type of heart failure.  The attending documented acute on chronic right-sided congestive heart failure.  Not sure where to go with this now.  Is I50.813 (acute on chronic right heart failure) the correct code assignment? 

Thank you.


  •  I would code the I50.813 for now.  In the future you may want to give the option of "Corpulmonale" in addition to the typical systolic/diastolic ones.  Systolic & diastolic HF are related to patient's LV dysfunction & Corpulmonale is seen with RV dysfunction & pulmonary HTN.  IS this patient moridly obese or have a chronic lung condition?--these can lead to right sided HF or Corpulmonale.  Please note Corpulmonale is coded as chronic even if documented as acute on chronic (I beleive there is a coding clinic on this).  The only exception is if patient is admitted for a PE-then a combo code of PE with acute corpulmonale would be used.  Hope this helps.

Sign In or Register to comment.