Tips for Coding Heart Failure

Tips for Coding Heart Failure

  • 16 Feb 0
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Sometimes, we providers use terms that are very specific and covey a tremendous amount of meaning. Two of those terms are “Ischemic Cardiomyopathy” and “Hypertensive Cardiomyopathy.” When I hear those terms I get a sense that there is dysfunction of the heart – “Heart Failure” – caused by coronary artery disease or hypertension.

If you use those terms, thinking that you have documented a specific type of Heart Failure and that you are capturing its associated HCC 85, think again.

The ICD 9 code for Ischemic Cardiomyopathy is 414.8 “Other Specific Forms of Ischemic Heart Disease.” This will capture an RxHCC 089 but no Part A,B HCC. If you use the term ischemic cardiomyopathy, be sure to add language such as “systolic heart failure,” “diastolic heart failure,” or “acute systolic on diastolic heart failure.”

In the same vein there is no ICD 9 code for the term “Hypertensive Cardiomyopathy.” You could use the more generic ICD 9 code 425.8 “Cardiomyopathy in other diseases classified elsewhere” or ICD 9 code 425.4 “Cardiomyopathy” which will map to the heart failure HCC. Otherwise, simply use the descriptive terms such as “systolic heart failure” that I mentioned above.