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Coding Newsletter - Congestive Heart Failure
Florida Blue·FL · Cardiology, Internal Medicine, Family Medicine +2 more·Coding
We identified it
Jun 16, 2026
Summary
Florida Blue has issued updated coding guidelines for Congestive Heart Failure (CHF) documentation and ICD-10 coding. The policy emphasizes specific documentation requirements for HF type, acuity, ejection fraction, and proper use of ICD-10 codes I50.2- through I50.84 to ensure accurate risk stratification and reimbursement.
Action Required
Immediately: Providers must document specific HF type (systolic, diastolic, combined), acuity (acute, chronic, acute on chronic), and ejection fraction when available for all CHF encounters. Billing team must update coding practices to use specific I50 codes instead of unspecified I50.9. Update EMR templates to include CHF documentation checklist and ensure coders capture mechanical support devices (LVAD, transplant status) with appropriate Z codes.