Cardiology Coding Alert

Question: There are so many acronyms pertinent to cardiology! What’s the difference between the acronyms HFrEF, HFpEF, HFmrEF, and HFrecEF?

Maryland Subscriber

Answer: While the acronyms may be confusing, you probably know the conditions that they refer to.

HFrEF: Heart failure with reduced ejection fraction, also known as systolic heart failure. A patient with systolic heart failure has a left ventricle that does not contract normally, which doesn’t allow their heart to pump with enough force to push sufficient blood into circulation. The clinical definition relies on an ejection fraction of less than 50 percent.

HFpEF: Heart failure with preserved ejection fraction, also known as diastolic heart failure. A patient with diastolic heart failure has a left ventricle whose muscle has become stiff. The muscle of the left ventricle no longer relaxes enough to allow the ventricle to fill with blood during the rest period between each heartbeat. The clinical definition relies on an ejection fraction of 50 percent or more.

HFmrEF: Heart failure with “mid-range” ejection fraction, with ejection fraction of 41-49 percent. Providers that use this acronym may define systolic heart failure as having an ejection fraction of less than 41 percent; the clinical significance between the two conditions is not yet known.

HFrecEF: Heart failure with recovered ejection fraction, which may be used to describe patients whose reduced ejection fraction has shown significant improvement. For example, patients who were experiencing systolic heart failure but received a transcatheter aortic valve replacement (TAVR) that caused their ejection fractions to improve might have the acronym “HFrecEF” in their medical record.

Rachel Dorrell, MA, MS, CPC-A, CPPM, Development Editor, AAPC