I50.812
BillableChronic right 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
The right side of the heart has long-term dysfunction and cannot pump blood effectively over an extended period.
Coding Tips
- •Confirm documentation indicates chronic or long-standing right heart failure
- •Do not use this code if there is evidence of acute exacerbation; use I50.813 instead
Clinical Significance
Chronic right heart failure reflects longstanding right ventricular dysfunction, typically from chronic pulmonary hypertension, chronic lung disease, or chronic left heart failure. These patients require ongoing management of both the right heart failure and its underlying cause. Annual recapture is important for reflecting the complexity and resource needs of these patients.
Documentation Requirements
- ✓Provider must document 'chronic' right heart failure or chronic right ventricular failure
- ✓Underlying etiology: pulmonary hypertension, chronic obstructive pulmonary disease, left heart failure
- ✓Signs of chronic right heart failure: chronic peripheral edema, hepatomegaly, ascites
- ✓Right ventricular function assessment
- ✓Current treatment plan and monitoring schedule
- ✓Absence of acute exacerbation — if worsening, code I50.813 instead
Commonly Confused Codes
I50.813 — Acute on chronic right heart failure: use when chronic disease has acute exacerbationI50.811 — Acute right heart failure: acute onset without pre-existing chronic diseaseI50.810 — Right heart failure, unspecified: does not specify chronicityI50.814 — Right heart failure due to left heart failure: specifically secondary to left heart diseaseI27.81 — Cor pulmonale (chronic): right heart failure specifically secondary to chronic lung disease
Code Hierarchy
└I50Heart failure└I50.8Other heart failure└I50.81Right heart failure└I50.812Chronic right heart failure
└I50.812Chronic right heart failure