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Clinical Documentation Improvement
Please Document the Acuity and Type of CHF:
 Acute
 Acute on Chronic
 Chronic
Diastolic Heart Failure
● Evidence of diastolic dysfunction =impaired relaxation; heart
does not properly let blood in.
● Evidence of normal ventricular systolic function with an EF >50% or
high normal EF due to smaller left ventricular size
●Concentric left ventricular hypertrophy/thickening & abnormal diastolic
filling resulting in impaired relaxation and poor filling
Systolic Heart Failure
●Evidence of systolic dysfunction =impaired contraction ;heart
does not properly let blood out due to thickened left ventricle
●EF < 40% or abnormally low EF
●Left ventricular dilation/enlargement & Low cardiac output from impaired
References: AHA: Heart Failure 04/03/2009, Cleveland Clinic Center for CME 2010 Robert Hobb
,M.D.,UCSF Academic Geriatric Resource Program 09/2007