Cardiology Coding Alert

Question: If coding heart failure and the provider states that the patient has systolic heart failure with exacerbation, would the correct code be I50.21 (Acute systolic (congestive) heart failure)? Does exacerbation equal acute?

Virginia Subscriber

Answer: Not necessarily. Exacerbation just means a flare-up; something is making the heart failure worse. “Acute systolic heart failure” means: “This patient’s heart was fine yesterday, but now it isn’t.” If that’s what's happening here, then I50.21 would be appropriate. However, if the patient has chronic heart failure, then it's probably just I50.20 (Unspecified systolic (congestive) heart failure).

Meagan Williford, BA, MA, CPC, Contributing Writer