Understanding Congestive Heart Failure Systolic (CHF Systolic), also known as Systolic Heart Failure or Heart Failure with Reduced Ejection Fraction (HFrEF)? This resource provides information on clinical documentation, medical coding, and healthcare best practices related to HFrEF diagnosis. Learn about symptoms, treatment, and the importance of accurate medical coding for systolic heart failure. Improve your clinical documentation and coding accuracy for congestive heart failure.
Also known as
Systolic heart failure
Heart failure with reduced ejection fraction.
Left ventricular failure
Failure of the left ventricle of the heart.
Heart failure, unspecified
Heart failure not otherwise specified.
Hypertensive heart disease with heart failure
Heart failure due to high blood pressure.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the heart failure systolic (HFrEF)?
Yes
Is it acute on chronic?
No
Do NOT code as systolic heart failure. Evaluate for other type of heart failure.
When to use each related code
| Description |
|---|
| Heart pumps weakly (reduced ejection fraction). |
| Heart pumps normally but filling is impaired. |
| Heart failure with mildly reduced EF. |
Coding CHF systolic without specifying systolic or diastolic type can lead to inaccurate severity and reimbursement.
Confusing HFrEF (reduced EF) with HFpEF (preserved EF) leads to incorrect coding and clinical documentation improvement issues.
Lack of documentation like EF values or clinical indicators to support systolic HF diagnosis can trigger audit denials and compliance risks.
Q: What are the most effective evidence-based management strategies for worsening systolic heart failure with reduced ejection fraction (HFrEF) in elderly patients?
A: Managing worsening systolic heart failure with reduced ejection fraction (HFrEF), particularly in elderly patients, requires a multifaceted approach grounded in current guidelines and evidence-based practice. Key strategies include optimizing guideline-directed medical therapy (GDMT) such as beta-blockers, ACE inhibitors/ARBs/ARNIs, mineralocorticoid receptor antagonists (MRAs), and SGLT2 inhibitors, while carefully considering age-related physiological changes and potential drug interactions. Loop diuretics play a crucial role in managing congestion and fluid overload, but require careful monitoring of renal function and electrolyte imbalances. Device therapy, including cardiac resynchronization therapy (CRT) for those meeting specific criteria, can further improve cardiac function and reduce symptoms. Furthermore, addressing comorbidities, such as diabetes, hypertension, and sleep apnea, is essential. Explore how palliative care can be integrated for symptom management and enhanced quality of life, especially in advanced stages. Consider implementing a comprehensive patient education plan that emphasizes medication adherence, lifestyle modifications (sodium restriction, fluid management), and self-care strategies. Learn more about the latest clinical trials investigating novel therapies for HFrEF.
Q: How can I differentiate between systolic and diastolic heart failure when interpreting echocardiogram results, specifically ejection fraction and other key parameters?
A: Differentiating between systolic and diastolic heart failure relies heavily on echocardiographic findings, especially left ventricular ejection fraction (LVEF). Systolic heart failure, or heart failure with reduced ejection fraction (HFrEF), is characterized by an LVEF of 40% or less, indicating impaired contractility. This is often accompanied by increased left ventricular end-diastolic and end-systolic volumes. In contrast, diastolic heart failure, also known as heart failure with preserved ejection fraction (HFpEF), presents with a normal or near-normal LVEF (typically >50%) but impaired ventricular relaxation and filling. Key echocardiographic parameters to consider include E/A ratio, E/e' ratio (tissue Doppler imaging), left atrial volume index, and diastolic function grading. While LVEF is a primary differentiator, it's crucial to interpret it in the context of the patient's clinical presentation, including symptoms, physical exam findings, and other diagnostic tests. Explore how advanced imaging techniques like strain imaging can provide additional insights into myocardial function and help further distinguish between HFrEF and HFpEF. Consider implementing a structured approach to echocardiogram interpretation to ensure accurate diagnosis and guide treatment decisions.
Patient presents with symptoms suggestive of congestive heart failure systolic, also known as systolic heart failure or heart failure with reduced ejection fraction (HFrEF). The patient reports dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea, and fatigue. Physical examination reveals pulmonary rales, peripheral edema, and an S3 gallop. The patient's medical history includes hypertension and coronary artery disease. Echocardiography demonstrates a left ventricular ejection fraction (LVEF) of 35%, confirming the diagnosis of HFrEF. The patient's current medications include lisinopril, metoprolol succinate, and furosemide. The treatment plan includes optimization of medical therapy with the addition of spironolactone and consideration for cardiac resynchronization therapy (CRT) if symptoms persist despite optimal medical management. Patient education was provided regarding lifestyle modifications including sodium restriction and fluid management. Follow-up appointment scheduled in two weeks to assess response to therapy and adjust medications as needed. Diagnosis: Congestive heart failure systolic (I50.2). ICD-10 code I50.2 is used for billing and coding purposes for heart failure with reduced ejection fraction. Differential diagnosis included diastolic heart failure and other causes of dyspnea, but these were ruled out based on the echocardiogram findings. The patient's prognosis is dependent upon their adherence to the treatment plan and response to therapy.