# Heart Failure systolic/diastolic



## rvalente (May 27, 2015)

Hi, can anyone weigh in on this directive I received from my employer? 

"You must also report the CHF code (428.0) when any of the diastolic or systolic diagnoses have been documented".

Is this from the coding clinic? 

TIA for your opinions


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## amoore (May 27, 2015)

*Congestive heart failure*

You do not need to post 428.0 with systolic or diastolic heart failure.  I have never heard or read this.  Angela Moore, CPC


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## tser05@yahoo.co.in (May 27, 2015)

*CHF with systolic or diastolic heart failure*

Yes there is coding clinic which says you can code CHF in addition to the systolic and diastolic heart failure series as CHF is not always integral to the systolic or diastolic heart failure hence we can code CHF in addition to the systolic or diastolic heart failure.



Below is the coding clinic to support CHF coded with diastolic or systolic heart failure.

VOLUME 21      FOURTH QUARTER

NUMBER 4        2004, Page 140

Clarification - Diastolic and Systolic Failure with Congestive Heart Failure

Question: According to Coding Clinic, Fourth Quarter 2002, pages 52-53, when a diagnosis is listed as systolic, diastolic, or combined systolic and diastolic congestive heart failure, code 428.0, Congestive heart failure, is reported in addition to the new codes that were created for systolic heart failure (428.20-428.23), diastolic heart failure (428.30-428.33), and combined systolic and diastolic heart failure (428.40-428.43).  While we understand that the additional code for the congestive heart failure is necessary for specificity, we would like clarification on this matter since there are no instructional notes to code also 428.0 or use additional code 428.0 printed in ICD-9-CM under subcategories 428.2, 428.3, or 428.4 (or programmed into the encoders).

Answer: The advice published in Coding Clinic, Fourth Quarter 2002, pages 52-53, is still valid.  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.  For example, a diagnosis of acute combined systolic and diastolic congestive heart, would be assigned two codes 428.41, Combined systolic and diastolic heart failure, acute, and 428.0, Congestive heart failure, unspecified.  Both codes are needed to report the specific type of heart failure, congestive, diastolic, and systolic.

New codes contained in this issue effective with discharges October 1, 2004.  Other coding advice or code assignments contained in this issue effective with discharges January 31, 2005.


Thanks
Dawa Tsering, CPC


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## BenCrocker (May 27, 2015)

That makes sense, if the Sys and Dia are mentioned.


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## lgardner (May 29, 2015)

does anyone have any more recent documentation about this?


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## KaylaR2007 (Jun 7, 2015)

CHF may be coded in addition to diastolic/systolic/combined heart failure if CHF is documented. If there is no CHF it would be 428.20, 428.30, 428.40 assuming these are unspecified. If there is mention of CHF it would be coded as 428.0, 428.22, 428.32, or 428.42. Because there is CHF the diastolic, systolic or combined would be coded as chronic.


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