Acute combined systolic and diastolic (congestive) hrt fail

This code signifies a severe form of heart failure where both the heart's ability to pump blood effectively (systolic dysfunction) and its ability to relax and fill with blood (diastolic dysfunction) are acutely impaired. This leads to symptoms of fluid overload and reduced cardiac output.

Apply this code when documentation explicitly states "acute combined systolic and diastolic heart failure" or "acute congestive heart failure with both systolic and diastolic dysfunction." This diagnosis is typically supported by findings such as acute decompensation, elevated B-type natriuretic peptide (BNP), and echocardiographic evidence of both reduced ejection fraction and impaired ventricular relaxation.

• Ensure documentation clearly specifies "acute" and "combined" (systolic and diastolic) to differentiate from chronic or single-type heart failure.
• Do not use this code if the heart failure is described as chronic, even if it is a combined type; use the appropriate chronic combined heart failure code.
• Always sequence this code as a primary diagnosis when it is the reason for the encounter, unless another condition is clearly identified as the principal diagnosis.