Documentation Tip: Heart Failure - Framingham Criteria

Posted on Wed, Aug 24, 2016
Documentation Tip: Heart Failure - Framingham Criteria

Our recurring series of documentation tips for clinicians.

By Timothy Brundage, MD

Reduce risk of denial for CHF admissions using the Framingham Criteria for CHF diagnosis.  

Document these each and every time along with the following:

  • Acute/Chronic (both)
  • Systolic/Diastolic (both)

Framingham Criteria:

  • Acute pulmonary edema
  • Cardiomegaly
  • Hepatojugular reflex
  • Neck vein distension (JVD)
  • Paroxysmal nocturnal dyspnea or orthopnea
  • Rales
  • Third heart sound gallop

  • Ankle edema
  • Dyspnea on exertion (DOE)
  • Hepatomegaly
  • Nocturnal cough
  • Pleural effusion
  • Tachycardia (>120bpm)

* Heart failure is diagnosed when two major criteria or one major and two minor criteria are met.


Dr. Timothy Brundage is a hospitalist for EmCare at St. Petersburg General Hospital in St. Petersburg, Fla. Dr. Brundage earned his bachelor’s degree in chemistry and molecular biology at the University of Michigan, his M.D. at the Wayne State University School of Medicine and completed his residency in internal medicine at the University of South Florida College of Medicine. Subscribe to Dr. Brundage’s weekly documentation tips, or ask him about specific documentation issues, by emailing him at

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