ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesI50.20

I50.20

Billable

Unspecified systolic (congestive) heart failure

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 I50.20 is a billable code used to indicate a diagnosis of unspecified systolic (congestive) heart failure.

Key Diagnostic Point:

Unspecified systolic (congestive) heart failure (CHF) is a condition characterized by the heart's inability to pump blood effectively, leading to inadequate blood flow to meet the body's needs. Clinically, patients may present with symptoms such as shortness of breath, fatigue, and fluid retention, which can manifest as swelling in the legs and abdomen. The anatomy involved primarily includes the left ventricle, which is responsible for pumping oxygenated blood to the body. Disease progression can vary, with some patients experiencing acute episodes while others may have a chronic course. Diagnostic considerations for I50.20 include a thorough patient history, physical examination, and diagnostic tests such as echocardiograms, chest X-rays, and blood tests to assess heart function and fluid status. It is essential to differentiate this condition from diastolic heart failure (I50.30) and other heart failure types to ensure appropriate management and treatment strategies.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires comprehensive evaluation to rule out other heart conditions.
  • Treatment complexity: Management may involve multiple medications and lifestyle changes.
  • Documentation requirements: Detailed clinical notes are necessary to support the diagnosis.
  • Coding specificity: While I50.20 is less specific than other heart failure codes, it requires careful consideration of symptoms and clinical findings.

Audit Risk Factors

  • Common coding errors: Misclassification of heart failure types.
  • Documentation gaps: Incomplete clinical notes leading to insufficient support for the diagnosis.
  • Billing challenges: Potential for denials if documentation does not clearly establish the diagnosis.

Specialty Focus

Medical Specialties

Cardiology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Primary Care

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Unspecified systolic heart failure significantly affects population health, contributing to increased morbidity and mortality rates. It is a leading cause of hospitalizations among older adults, impacting healthcare utilization patterns. Quality measures often focus on timely diagnosis and effective management of heart failure to improve patient outcomes. Epidemiologically, heart failure prevalence is rising, necessitating ongoing public health initiatives to address risk factors and improve care delivery.

ICD-9 vs ICD-10

Unspecified systolic heart failure significantly affects population health, contributing to increased morbidity and mortality rates. It is a leading cause of hospitalizations among older adults, impacting healthcare utilization patterns. Quality measures often focus on timely diagnosis and effective management of heart failure to improve patient outcomes. Epidemiologically, heart failure prevalence is rising, necessitating ongoing public health initiatives to address risk factors and improve care delivery.

Reimbursement & Billing Impact

reimbursement. Regular audits of coding practices can help identify areas for improvement and ensure compliance with billing requirements.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for I00-I99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for I00-I99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by I50.20?

I50.20 covers unspecified systolic heart failure, which may include patients with chronic heart failure who do not fit into more specific categories. It is essential to document the patient's symptoms and clinical findings to support this diagnosis.

When should I50.20 be used instead of related codes?

I50.20 should be used when the specific type of systolic heart failure is not documented or when the clinical presentation does not meet the criteria for acute or chronic heart failure. It is crucial to ensure that the documentation reflects the patient's condition accurately.

What documentation supports I50.20?

Documentation for I50.20 should include a detailed patient history, physical examination findings, results from diagnostic tests (e.g., echocardiogram, BNP levels), and any treatment plans. Clear notes on the patient's symptoms and their impact on daily activities are also essential.