Abstract 15810: Relationship Between Left Ventricular Ejection Fraction and ICD-10 Codes Among Patients Hospitalized for Heart Failure

Abstract

Introduction: International Classification of Diseases (ICD)-10 codes are routinely used to classify patients with heart failure (HF). Although these codes play an important role with case identification and reimbursement, they are perceived to lack clinical specificity. Goals/Aims: We sought to describe the relationship between HF type (based on left ventricular ejection fraction [LVEF]) and assigned HF ICD-10 code in a large real-world dataset. Methods: We performed a retrospective cross-sectional analysis of patients admitted to a large health system within the western US between 1/1/18 and 10/1/2022 with a principal diagnosis of HF (ICD-10 codes: I50.2, systolic HF; I50.3, diastolic HF; I50.4, combined systolic and diastolic HF; I11.0, hypertensive heart disease with HF; and I13.0 and I13.2, hypertensive heart disease with HF and chronic kidney disease [CKD]). The analysis was further limited to patients with an LVEF by echocardiography in the 3 months preceding hospital discharge. Results: Over nearly 5 years, 61,238 HF hospitalizations occurred, of which 49,772 (81%) had an LVEF available. Most patients admitted with systolic HF (4.4% of the cohort) as well as systolic and diastolic HF (3.2% of the cohort) had an LVEF ≤40% (86.2% and 74.8%, respectively); similarly, most patients admitted with diastolic HF (3.1% of the cohort) had an LVEF ≥50% (94.0%) (Figure). Those admitted with hypertensive heart disease with HF (36.3% of the cohort) and hypertensive heart disease with HF and CKD (52.9% of the cohort) had a much wider LVEF distribution (Figure). Conclusions: Although relatively good concordance was noted between LVEF and ICD-10 codes for systolic HF, diastolic HF, and systolic and diastolic HF, this was not the case for most HF hospitalizations. This should be considered when performing analyses with HF ICD-10 codes.