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ICD-10 Guide
ICD-10 CodesI50.82

I50.82

Billable

Biventricular heart failure

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

Code Description

ICD-10 I50.82 is a billable code used to indicate a diagnosis of biventricular heart failure.

Key Diagnostic Point:

Biventricular heart failure (HF) is a complex condition characterized by the simultaneous failure of both the left and right ventricles of the heart, leading to inadequate blood circulation and resultant systemic and pulmonary congestion. Clinically, patients may present with symptoms such as dyspnea, fatigue, peripheral edema, and ascites. The anatomy involved includes the heart's ventricles, valves, and associated vascular structures, which may be affected by underlying conditions such as ischemic heart disease, hypertension, or cardiomyopathy. Disease progression can vary, with acute exacerbations often triggered by factors such as noncompliance with medications, dietary indiscretions, or infections. Diagnostic considerations include a thorough clinical evaluation, echocardiography, and possibly cardiac MRI or CT to assess ventricular function and structure. Laboratory tests, including BNP levels, can also aid in diagnosis and monitoring of heart failure severity.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Diagnostic complexity: Requires comprehensive evaluation of cardiac function and potential underlying causes.
  • Treatment complexity: Involves a multidisciplinary approach including pharmacologic management, lifestyle modifications, and possibly device therapy.
  • Documentation requirements: Requires detailed clinical documentation to support the diagnosis and treatment plan.
  • Coding specificity: High specificity needed to differentiate between types of heart failure.

Audit Risk Factors

  • Common coding errors: Misclassification of heart failure type or severity.
  • Documentation gaps: Incomplete clinical notes or lack of supporting evidence for diagnosis.
  • Billing challenges: Potential denials due to insufficient documentation or incorrect code selection.

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

Biventricular heart failure significantly impacts population health, contributing to high morbidity and mortality rates. It is a leading cause of hospitalizations among older adults, resulting in substantial healthcare utilization and costs. Quality measures focus on timely diagnosis, effective management, and patient education to improve outcomes. Epidemiologically, the prevalence of heart failure is rising, necessitating ongoing public health efforts to address risk factors and enhance care delivery.

ICD-9 vs ICD-10

Biventricular heart failure significantly impacts population health, contributing to high morbidity and mortality rates. It is a leading cause of hospitalizations among older adults, resulting in substantial healthcare utilization and costs. Quality measures focus on timely diagnosis, effective management, and patient education to improve outcomes. Epidemiologically, the prevalence of heart failure is rising, necessitating ongoing public health efforts to address risk factors and enhance care delivery.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of care provided, which may involve multiple specialists and interventions. Common denials can arise from insufficient documentation or failure to demonstrate medical necessity for procedures and medications. Best practices include maintaining thorough clinical notes, ensuring accurate coding, and regularly reviewing payer guidelines to avoid billing issues.

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 I50.82?

I50.82 covers conditions where both left and right ventricular heart failure are present, often seen in patients with advanced heart disease, pulmonary hypertension, or severe valvular heart disease.

When should I50.82 be used instead of related codes?

I50.82 should be used when both ventricles are failing, as indicated by clinical symptoms and diagnostic tests, differentiating it from codes that specify left or right heart failure alone.

What documentation supports I50.82?

Documentation should include clinical findings, diagnostic imaging results, laboratory tests, and a comprehensive treatment plan that reflects the severity and management of biventricular heart failure.