Cardiology Coding Alert

Question: I’m new to cardiology and was wondering if you could explain the heart failure scales?

Wisconsin Subscriber

Answer: There are two scales which classify the severity and stage of heart failure: the New York Heart Association (NYHA) scale and the American College of Cardiology (ACC)/American Heart Association (AHA).

NYHA scale: The NYHA has a symptom-based scale, and the patient will be put into one of the following four categories based on their symptoms:

• Class 1 – The patient doesn’t experience any symptoms at any time.
• Class 2 – The patient can perform daily activities with ease but feels fatigued or winded when they exert themselves.
• Class 3 – The patient has difficulties completing daily activities.
• Class 4 – The patient feels short of breath, even at rest.

ACC/AHA scale: The ACC/AHA scale is a stage-based system. It is as follows:

• Stage A – The patient has one or more risk factors for heart failure, but they aren’t experiencing any symptoms.
• Stage B – The patient has heart disease but doesn’t have any signs or symptoms of heart failure.
• Stage C – The patient has heart disease and is experiencing signs or symptoms of heart failure.
• Stage D – The patient has advanced heart failure that requires specialized treatments.