I50.82

HCC Category Mapping

What This Code Means

Both the right and left sides of the heart are not functioning properly at the same time, affecting the heart's overall ability to pump blood.

Coding Tips

• •Ensure documentation explicitly states biventricular involvement or failure of both ventricles
• •Do not use this code if only one ventricle is affected; use the appropriate single-ventricle code instead

Clinical Significance

Biventricular heart failure indicates that both the left and right ventricles are failing simultaneously, representing advanced cardiac disease with poor prognosis. These patients have significantly higher mortality and resource utilization compared to isolated left or right heart failure. Complete documentation of both ventricles' dysfunction is critical.

Documentation Requirements

• ✓Provider must document biventricular heart failure or bilateral heart failure
• ✓Echocardiographic evidence of both left and right ventricular dysfunction
• ✓Functional status and New York Heart Association class
• ✓Current comprehensive treatment plan
• ✓Signs and symptoms of both left-sided (dyspnea, pulmonary edema) and right-sided (peripheral edema, ascites) failure
• ✓Whether the patient is being evaluated for advanced therapies (transplant, ventricular assist device)

Commonly Confused Codes