I50.30
BillableUnspecified diastolic (congestive) heart failure
HCC Category Mapping
V28HCC 226 — Heart Failure, Specified
0.000V24HCC 85 — Congestive Heart Failure
0.368ESRDHCC 85 — Congestive Heart Failure
0.000RxHCCHCC 186 — Heart Failure
0.000What This Code Means
A heart condition where the heart muscle cannot relax properly between beats, preventing adequate filling with blood, but the specific severity or duration is not specified.
Coding Tips
- •Use only when documentation does not specify acute, chronic, or acute on chronic status
- •Query provider if severity/duration information is available to assign more specific code
Clinical Significance
Unspecified diastolic congestive heart failure (heart failure with preserved ejection fraction) occurs when the heart muscle is stiff and cannot relax properly to fill with blood. This type of heart failure is increasingly prevalent, particularly in elderly patients with hypertension and diabetes. Acuity specification should always be pursued for optimal coding.
Documentation Requirements
- ✓Provider must document diastolic heart failure, diastolic dysfunction with heart failure, or heart failure with preserved ejection fraction
- ✓Ejection fraction value — typically 50% or greater in diastolic heart failure
- ✓Echocardiographic evidence of diastolic dysfunction (impaired relaxation, elevated filling pressures)
- ✓Acuity should be specified — this unspecified code is used only when acute, chronic, or acute on chronic is not documented
- ✓Current medications and treatment plan
- ✓Underlying contributing conditions such as hypertension, diabetes, or obesity
Commonly Confused Codes
I50.31 — Acute diastolic heart failure: use when documented as acute onsetI50.32 — Chronic diastolic heart failure: use when documented as chronic or long-standingI50.33 — Acute on chronic diastolic heart failure: use when chronic disease has acute exacerbationI50.20 — Unspecified systolic heart failure: systolic involves reduced ejection fractionI50.40 — Unspecified combined systolic and diastolic heart failure: when both types are present
Code Hierarchy
└I50Heart failure└I50.3Diastolic (congestive) heart failure└I50.30Unspecified diastolic (congestive) heart failure
└I50.30Unspecified diastolic (congestive) heart failure