Acute on chronic combined systolic and diastolic hrt fail

This code signifies a severe exacerbation of pre-existing heart failure, characterized by the simultaneous worsening of both the heart's pumping (systolic) and filling (diastolic) functions. The "acute on chronic" designation indicates a sudden, significant deterioration of a long-standing combined heart failure condition.

This code is appropriate when a patient with a documented history of combined systolic and diastolic heart failure experiences an acute decompensation requiring increased medical intervention. Documentation should clearly specify the acute worsening of both systolic and diastolic dysfunction, often presenting with symptoms like acute pulmonary edema or severe dyspnea.

• Ensure documentation explicitly states "acute on chronic" and specifies both systolic and diastolic involvement.
• Do not use if only one type of heart failure (systolic or diastolic) is acutely exacerbated, or if the heart failure is purely acute.
• Sequence this code as the principal diagnosis when it is the primary reason for the encounter, followed by any underlying causes.