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ICD-10 Guide
ICD-10 CodesI50.23

I50.23

Billable

Acute on chronic systolic (congestive) heart failure

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

Code Description

ICD-10 I50.23 is a billable code used to indicate a diagnosis of acute on chronic systolic (congestive) heart failure.

Key Diagnostic Point:

Acute on chronic systolic (congestive) heart failure is a condition characterized by the sudden exacerbation of heart failure symptoms in patients who have a history of chronic systolic heart failure. Clinically, patients may present with worsening dyspnea, fatigue, and edema due to fluid overload. The anatomy involved primarily includes the left ventricle, which is responsible for pumping oxygenated blood to the body. In chronic heart failure, the heart's ability to pump effectively is compromised, often due to conditions such as ischemic heart disease, hypertension, or cardiomyopathy. The acute exacerbation can be triggered by factors such as infections, noncompliance with medications, or dietary indiscretions. Diagnostic considerations include a thorough clinical assessment, echocardiography to evaluate left ventricular function, and laboratory tests to assess renal function and electrolyte balance. Management typically involves diuretics, ACE inhibitors, and beta-blockers, tailored to the patient's specific needs and underlying causes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors include misclassification of acute versus chronic heart failure.
  • Documentation gaps may arise if the chronic condition is not clearly stated in the medical record.
  • Billing challenges often stem from insufficient documentation to support the acute exacerbation.

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

Internal Medicine

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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Acute on chronic systolic heart failure significantly impacts population health, contributing to high hospitalization rates and healthcare costs. It is a leading cause of morbidity and mortality among older adults. Quality measures often focus on reducing readmission rates for heart failure patients, highlighting the importance of effective management and patient education. Understanding the epidemiology of this condition can help healthcare providers develop targeted interventions to improve patient outcomes and reduce healthcare utilization.

ICD-9 vs ICD-10

Acute on chronic systolic heart failure significantly impacts population health, contributing to high hospitalization rates and healthcare costs. It is a leading cause of morbidity and mortality among older adults. Quality measures often focus on reducing readmission rates for heart failure patients, highlighting the importance of effective management and patient education. Understanding the epidemiology of this condition can help healthcare providers develop targeted interventions to improve patient outcomes and reduce healthcare utilization.

Reimbursement & Billing Impact

Acute on chronic systolic heart failure significantly impacts population health, contributing to high hospitalization rates and healthcare costs. It is a leading cause of morbidity and mortality among older adults. Quality measures often focus on reducing readmission rates for heart failure patients, highlighting the importance of effective management and patient education. Understanding the epidemiology of this condition can help healthcare providers develop targeted interventions to improve patient outcomes and reduce healthcare utilization.

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 I50.23?

I50.23 covers patients with a documented history of chronic systolic heart failure who experience an acute exacerbation. This includes those with underlying ischemic heart disease, hypertension, or other cardiomyopathies that lead to a decline in cardiac function.

When should I50.23 be used instead of related codes?

I50.23 should be used when there is clear documentation of chronic systolic heart failure with an acute exacerbation. It is distinct from I50.21, which is used for acute heart failure without a chronic component.

What documentation supports I50.23?

Documentation should include a history of chronic systolic heart failure, recent clinical findings indicating an acute exacerbation, and any relevant diagnostic tests that confirm the patient's current status.