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Compare/I50.1 vs J81

I50.1 vs J81

I50.1 (Left ventricular failure, unspecified) compared with J81 (Pulmonary edema), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.

Can these codes be reported together?

No — do not report together. I50.1 carries an Excludes1 note covering J81: “edema of lung without heart disease or heart failure (J81.-)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

No — do not report together. I50.1 carries an Excludes1 note covering J81: “pulmonary edema without heart disease or failure (J81.-)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

No — do not report together. J81 carries an Excludes1 note covering I50.1: “pulmonary edema with heart disease NOS (I50.1)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

No — do not report together. J81 carries an Excludes1 note covering I50.1: “pulmonary edema with heart failure (I50.1)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Side by side

I50.1Left ventricular failure, unspecifiedJ81Pulmonary edema
Billing statusBillableNon-billable header

Report instead: J81.0, J81.1

ClassificationI00-I99 — Diseases of the Circulatory System (I00-I99)J00-J99 — Diseases of the Respiratory System (J00-J99)
DefinitionLeft ventricular failure, unspecified is a billable ICD-10-CM diagnosis code (I50.1).Pulmonary edema is a non-billable ICD-10-CM category code (J81).
Includes
Cardiac asthma
Edema of lung with heart disease NOS
Edema of lung with heart failure
Left heart failure
Use additional code
code to identify:
exposure to environmental tobacco smoke (Z77.22)
history of tobacco dependence (Z87.891)
Code first
heart failure complicating abortion or ectopic or molar pregnancy (O00-O07, O08.8)
heart failure due to hypertension (I11.0)

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources