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I50 ICD-10-CM Code: Heart failure

Billing Status: NO. This is a clinician non-billable / parent hierarchy grouping in the ICD-10-CM system.

Coding at a Glance

Tabular directives
2 Excludes2 · 6 code-first instructions

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for I50 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Code First

Underlying conditions that must be sequenced before this code.

  • heart failure complicating abortion or ectopic or molar pregnancy (O00-O07, O08.8)
  • heart failure due to hypertension (I11.0)
  • heart failure due to hypertension with chronic kidney disease (I13.-)
  • heart failure following surgery (I97.13-)
  • obstetric surgery and procedures (O75.4)
  • rheumatic heart failure (I09.81)

Coder workflow for I50

MedCoder structured workflow — derived from this code’s own official record

Before you code I50

  1. I50 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

    ReviewI50.1, I50.2, I50.3, I50.4, I50.8, I50.9

    See the relationships section · Guide: How to choose an ICD-10-CM code →

Choose the right path

  1. Does the documentation support one of the more specific codes beneath I50?
    Yes → Select that code and continue the checks below on its own page.
    No → I50 cannot be reported as written; query for the specificity its subcategory needs.

    ReviewI50.1, I50.2, I50.3, I50.4, I50.8, I50.9

  2. Is the underlying (etiologic) condition the Code First note names documented?
    Yes → Sequence the underlying condition first, then I50.
    No → Continue; do not add an underlying condition the record does not document.

    ReviewO08.8, I11.0, I13, I97.13, O75.4, I09.81

Consider I50. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
The underlying (etiologic) condition
Named in the Code First note; sequenced before this code when documented (Guidelines I.A.13).

Official instructions as workflow

  • Excludes2 — not part of I50(2 notes)

    Coding workflow: The conditions named in this note are not included in I50. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareI46, P29.0

    See the official tabular notes · Guidelines I.A.12.b

  • Code First — sequencing check(6 notes)

    Coding workflow: Check whether the underlying or etiologic condition the note names is documented. When it is, sequence it before I50. Do not add an underlying condition the record does not document.

    ReviewO08.8, I11.0, I13, I97.13, O75.4, I09.81

    See the official tabular notes · Guidelines I.A.13

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: The underlying condition the Code First note names is documented alongside this condition.

Coding question: How are the two sequenced?

Path: Review the Code First note.

Reason: The underlying condition is sequenced first and the manifestation follows (Guidelines I.A.13).

ReviewO08.8, I11.0, I13, I97.13, O75.4, I09.81

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Code Overview

Heart failure is a non-billable ICD-10-CM category code (I50). A more specific billable subcode must be selected for claims submission.

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Official Coding Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Verbatim excerpts from the ICD-10-CM Official Guidelines for Coding and Reporting (CMS/NCHS) that govern this code.

Chapter 9: Diseases of the Circulatory System (I00 -I99)

1) Hypertension with Heart Disease Hypertension with heart conditions classified to I50.-, Heart failure, I51.4, Myocarditis, unspecified, I51.89, Other ill-defined heart diseases, and I51.9, Heart disease, unspecified, is assigned to a code from category I11, Hypertensive heart disease. Use additional code(s) from category I50, Heart failure, or I51, Complications and ill-defined descriptions of heart disease, to identify the heart condition.

Chapter 9: Diseases of the Circulatory System (I00 -I99)

The same heart conditions (I50.-, I51.4-I51.7, I51.89, I51.9) with hypertension are coded separately if the provider has documented they are unrelated to the hypertension. The applicable hypertension code I10, Essential (primary) hypertension, or a code from category I15, Secondary hypertension, should be assigned. Sequence according to the circumstances of the admission/encounter.

Chapter 9: Diseases of the Circulatory System (I00 -I99)

3) Hypertensive Heart and Chronic Kidney Disease The codes in category I13, Hypertensive heart and chronic kidney disease, are combination codes that include hypertension, heart disease and chronic kidney disease. Assign codes from combination category I13, Hypertensive heart and chronic kidney disease, when there is hypertension with both heart and chronic kidney disease. If heart failure is present, assign an additional code from category I50 to identify the type of heart failure.

Verify Before Coding

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name I50 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Excludes2 note: J91 — Pleural effusion in conditions classified elsewhere.

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Referenced by 1 Code First instruction: I5A — Non-ischemic myocardial injury (non-traumatic).

Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.

Referenced by 5 Use Additional Code instructions: I09.81 — Rheumatic heart failure, I11.0 — Hypertensive heart disease with heart failure, I13.0 — Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease, I13.2 — Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease, I97.13 — Postprocedural heart failure.

These codes instruct coders to additionally report this code when it applies.

Referenced by 4 Code Also instructions across 2 chapters: E83.820 — Generalized arterial calcification of infancy with unspecified genetic causality, E83.821 — ENPP1 deficiency causing generalized arterial calcification of infancy, E83.823 — ABCC6 deficiency causing generalized arterial calcification of infancy, I16.1 — Hypertensive emergency.

These codes suggest coding this condition alongside when both are present.

Contextual Map

Every relationship of I50 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run I50 with these 18 related codes in Claim Check

Hierarchy

Excludes2

Code First (12)

Referenced by Excludes2 notes

Referenced by Code First instructions

Referenced by Use Additional Code instructions

Referenced by Code Also instructions

Nearest codes (28)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Common coding questions

Can I50 be billed directly?

No. I50 (Heart failure) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2026), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Heart failure

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to I50 in its code family, with their registry titles.