Heart failure coding is fraught with complexities, from capturing the severity and type of the condition to ensuring proper documentation of underlying causes and comorbidities. Errors such as improper sequencing, unbundling, or failure to reflect the true clinical picture can lead to claim denials, underpayments, and compliance risks. These issues not only impact financial performance but also hinder quality metrics that are crucial to improving patient outcomes.

Challenges in heart failure coding stem from insufficient education on ICD-10-CM guidelines, leading to inaccuracies like invalid diagnosis sequencing and inappropriate code selection. Other factors include inadequate documentation of comorbidities such as CKD and hypertension, unbundling diagnoses when combination codes are more appropriate, and over- or under-coding severity levels. Without a clear understanding of the guidelines and regular audits, these issues can compromise compliance and revenue integrity.

Led by Emily Montemayor, CCS, CMBCS, COC, CPC, CPMA, this webcast provides actionable strategies to navigate the complexities of heart failure coding. You will learn how to accurately sequence diagnoses, apply combination codes, and recognize common gaps in documentation while adhering to updated ICD-10-CM guidelines. With real-world examples and expert insights, you will gain the tools needed to improve coding accuracy, reduce denials, and ensure clean claims. This knowledge will empower you to address coding challenges effectively and protect your organization’s financial health.

Why This is Relevant:

Heart failure is one of the most prevalent and costly chronic conditions, impacting millions of lives annually. Accurate and compliant coding is critical for proper reimbursement and patient care. This topic is especially relevant as it requires expertise in applying diagnosis sequencing, capturing comorbidities, and ensuring medical necessity. Mastering these skills enables coding professionals to prevent claim denials, support compliance, and improve financial outcomes, making them indispensable in the evolving healthcare landscape.

Learning Objectives:

By attending this webcast, you will:

• Build a foundational understanding of heart failure’s clinical aspects to improve coding accuracy.
• Recognize and code comorbidities such as CKD and hypertension to reflect a comprehensive clinical picture.
• Apply ICD-10-CM guidelines effectively to ensure compliant and accurate coding for various heart failure types.
• Strengthen documentation practices by addressing key CDI criteria to bridge common gaps.
• Solve real-world coding challenges using practical examples, reinforcing knowledge for immediate application.

Who Should Attend:

Coding educators, coding compliance staff, clinical documentation integrity specialists (CDISs) CDI physician advisors, health information management (HIM) professionals, coding professionals, coding auditing professionals, coding managers and supervisors.