I50.813
BillableAcute on chronic right heart failure
HCC Category Mapping
V28HCC 225 — Acute Heart Failure
0.000V24HCC 85 — Congestive Heart Failure
0.368ESRDHCC 85 — Congestive Heart Failure
0.000RxHCCHCC 186 — Heart Failure
0.000What This Code Means
A patient with long-term right heart failure experiences a sudden worsening or acute episode on top of their chronic condition.
Coding Tips
- •Documentation must clearly indicate both chronic right heart failure and an acute exacerbation
- •This code captures the combination of pre-existing chronic disease with acute decompensation
Clinical Significance
Acute on chronic right heart failure represents acute decompensation of longstanding right ventricular dysfunction. This typically occurs from worsening pulmonary hypertension, acute respiratory illness, or progression of underlying cardiac disease. These patients require urgent intervention while also managing their chronic disease.
Documentation Requirements
- ✓Documentation must clearly indicate BOTH chronic right heart failure AND acute exacerbation
- ✓Evidence of pre-existing chronic right heart failure
- ✓Evidence of acute worsening: new or increased edema, worsening hepatic congestion, ascites progression
- ✓Precipitating factor for decompensation
- ✓Right ventricular function assessment during acute episode
- ✓Treatment plan for both acute stabilization and chronic management
Commonly Confused Codes
I50.811 — Acute right heart failure: use only for new onset without chronic historyI50.812 — Chronic right heart failure: use when stable without acute worseningI50.810 — Right heart failure, unspecified: does not specify acuityI50.23 — Acute on chronic systolic heart failure: left-sided heart failureI50.814 — Right heart failure due to left heart failure: etiology-specific, not acuity-specific
Code Hierarchy
└I50Heart failure└I50.8Other heart failure└I50.81Right heart failure└I50.813Acute on chronic right heart failure
└I50.813Acute on chronic right heart failure