I50.810
BillableRight heart failure, unspecified
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
The right side of the heart is not functioning properly, but the specific type or severity is not specified in the medical record.
Coding Tips
- •Use this code only when documentation does not specify acute, chronic, or the underlying cause
- •Review clinical notes to determine if a more specific right heart failure code (I50.811-814) should be assigned instead
Clinical Significance
Right heart failure, unspecified, indicates the right ventricle cannot effectively pump blood to the lungs for oxygenation. This is often secondary to left heart failure, pulmonary hypertension, or chronic lung disease. Specificity regarding acuity and underlying cause should always be pursued for optimal coding and risk adjustment.
Documentation Requirements
- ✓Provider must document right heart failure or right ventricular failure as an active diagnosis
- ✓Underlying etiology if known — left heart failure, pulmonary hypertension, chronic obstructive pulmonary disease, pulmonary embolism
- ✓Acuity should be specified — this code is used when acute, chronic, or acute on chronic is not documented
- ✓Signs and symptoms: peripheral edema, jugular venous distension, hepatomegaly, ascites
- ✓Echocardiographic findings including right ventricular size and function
- ✓Current treatment plan
Commonly Confused Codes
I50.811 — Acute right heart failure: when documented as acute onsetI50.812 — Chronic right heart failure: when documented as chronicI50.813 — Acute on chronic right heart failure: when chronic disease has acute exacerbationI50.814 — Right heart failure due to left heart failure: when right failure is secondary to left heart diseaseI27.81 — Cor pulmonale (chronic): right heart failure specifically due to chronic lung disease
Code Hierarchy
└I50Heart failure└I50.8Other heart failure└I50.81Right heart failure└I50.810Right heart failure, unspecified
└I50.810Right heart failure, unspecified