HCC coders should carefully review the patients' health records with known conditions associated with Heart failure (CAD, Renal failure, Hyperthyroidism, MI, Heart valve disorder, Arrhythmia, Sarcoidosis) for any signs and symptoms. Look at the medication list. Are there any medications indicating a treatment of Chronic Heart Failure? Review the medication orders for any adjustment in P. O. medication dosage or the evidence of a P.O. medication being changed to an IV route. This may indicate an exacerbation of chronic Heart failure. Report decompensated Heart Failure as an Acute on chronic Heart Failure.
Advanced structural Heart disease and symptoms with little or no physical exertion are the hallmarks of End-stage Heart failure. According to AHA's Coding Clinic, the ACC (American College Cardiology) and AHA (American Heart Association) classify Heart Failure in Stages, with End-Stage Heart failure falling into stage D.
End-Stage Heart Failure also falls into class III or IV of the NYHA (New-York Heart Association) functional classification. It is determined by the limitations that heart failure puts on physical activity.
About Stage B and Stage C heart failure, when you go to the index part of ICD-10-CM book 2021, you will see the following:
· Stage B Heart Failure............... See also Failure, Heart, by type (I50.9)
· Stage C Heart Failure............... See also Failure, Heart, by type (I50.9)
Stage A heart failure is a risk of Heart failure, but it is not Heart Failure. Report Stage A Heart Failure with code Z91.89 (other specified personal Risk factors, not elsewhere classified), according to AHA's Coding Clinic. Never report Stage A Heart Failure with I50.9