End stage heart failure

This code signifies the most severe and advanced form of heart failure, where conventional treatments are no longer effective, and the heart's ability to pump blood is critically impaired. Patients with end-stage heart failure often experience profound symptoms at rest and have a poor prognosis.

Apply this code when documentation explicitly states "end-stage heart failure" or indicates a patient with severe, refractory heart failure despite optimal medical management, often requiring advanced therapies like transplant evaluation or palliative care. Supporting documentation should reflect the chronicity and severity of the condition, including NYHA Class IV symptoms.

• Do not confuse with other unspecified or chronic heart failure codes; "end-stage" must be clearly documented.
• Always code any underlying cause of heart failure (e.g., ischemic cardiomyopathy) as an additional diagnosis.
• Consider sequencing this code as a primary diagnosis when it is the main reason for the encounter or admission.