Related Experiment Video
Updated: Sep 10, 2025
Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
Published on: June 10, 2025
Temporal shift in prevalence of heart failure diagnoses and comorbidities within 2 US integrated health systems
Mario Enrico Canonico1, Judith Hsia, Shih-Ting Chiu
1CPC Clinical Research and University of Colorado, 2115 N Scranton St #2040, Aurora, CO 80045-7120.
Insights
Heart failure (HF) coding trends show a shift towards hypertensive heart disease with and without chronic kidney disease (CKD), now representing most hospitalizations. Standardized coding is needed for better research and quality improvement.
Area of Science:
- Cardiology
- Health Informatics
- Public Health
Background:
- Heart failure (HF) is a major cause of hospitalization.
- Accurate coding of HF diagnoses is crucial for research and quality assessment.
- International Classification of Diseases, Tenth Revision (ICD-10) codes are used for disease classification.
Purpose of the Study:
- To analyze trends in ICD-10 codes assigned to heart failure hospitalizations.
- To compare coding practices between two large US health systems from 2018 to 2022.
- To identify predominant HF diagnostic codes.
Main Methods:
- Retrospective cross-sectional analysis of ICD-10 codes.
- Inclusion of patients hospitalized with a primary HF diagnosis between 2018-2022.
- Analysis of specific ICD-10 codes for systolic HF, diastolic HF, combined HF, hypertensive heart disease with HF, and hypertensive heart disease with HF and CKD.
Main Results:
- Hypertensive heart disease with HF and CKD (42%-56%) and hypertensive heart disease with HF (34%-42%) were the most common HF codes, comprising 85%-90% of hospitalizations.
- Systolic, diastolic, and combined HF codes represented only 9%-18% of hospitalizations.
- Significant variability in hypertension prevalence was noted between health systems for specific codes.
Conclusions:
- A significant shift in HF coding towards hypertensive heart disease diagnoses has occurred.
- Current coding practices show a predominance of hypertensive heart disease with and without CKD.
- Standardized coding practices are essential for quality improvement and health services research in HF.
Objective:
To assess trends in assigned International Statistical Classification of Diseases, Tenth Revision ( ICD-10 ) codes for patients hospitalized with heart failure (HF) from 2018 to 2022 in 2 large US health systems.
Study Design:
Retrospective cross-sectional analysis of ICD-10 codes assigned to patients hospitalized with HF in the Providence Health and University of Colorado Health (UCHealth) systems.
Methods:
The study included patients discharged from the Providence Health and UCHealth systems between 2018 and 2022 with a primary diagnosis of HF. ICD-10 codes analyzed included systolic HF (I50.2), diastolic HF (I50.3), combined systolic and diastolic HF (I50.4), hypertensive heart disease with HF (I11.0), and hypertensive heart disease with HF and chronic kidney disease (CKD) (I13.0, I13.2). Hospitalization data were analyzed separately for each health system due to privacy policies.
Results:
Between 2018 and 2022, 61,238 HF hospitalizations occurred in the Providence Health system, and 13,576 occurred in UCHealth. Hypertensive heart disease with HF and CKD was the most common diagnosis, accounting for 42% to 56% of HF hospitalizations, followed by hypertensive heart disease with HF (34%-42%). Together, these diagnoses represented 85% to 90% of HF hospitalizations. Systolic, diastolic, and combined HF codes accounted for only 9% to 18% of hospitalizations. Significant variability in hypertension prevalence (ie, 100% in Providence Health and 38%-39% in UCHealth) was observed between the 2 health systems in patients with codes I13.0 and I13.2.
Conclusions:
The study highlighted a significant shift in HF diagnosis codes, with hypertensive heart disease with HF with and without CKD now predominant. The findings highlight the need for standardized coding practices across health systems for quality improvement initiatives and health services research.
More Related Videos
06:55Inverse Probability of Treatment Weighting Propensity Score using the Military Health System Data Repository and National Death Index
Published on: January 8, 2020
10:46A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data
Published on: December 9, 2015
Related Concept Videos
01:30Heart Failure IV: Classification and Diagnostic Evaluation
01:29Heart Failure II: Pathophysiology
01:26Heart Failure III: Clinical Manifestations
01:27Heart Failure I: Introduction
01:30Heart Failure V: Medical Management
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies