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I50.2 ICD-10-CM Code: Systolic (congestive) 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 inclusion terms · 1 Excludes1 · 2 Excludes2 · 6 code-first instructions · 1 code-also instruction

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for I50.2 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on I50.2 itself; “inherited from” names the category or block whose note applies here.

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Heart failure with reduced ejection fraction [HFrEF]
  • Systolic left ventricular heart failure

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Excludes2 — Not Included Here

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

Source: inherited from I50

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)

Source: inherited from I50

Code Also

Additional codes that may be required to fully describe the encounter.

  • end stage heart failure, if applicable (I50.84)

Coder workflow for I50.2

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

Before you code I50.2

  1. I50.2 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).

    ReviewI50.20, I50.21, I50.22, I50.23

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

  2. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with I50.2. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support one of the more specific codes beneath I50.2?
    Yes → Select that code and continue the checks below on its own page.
    No → I50.2 cannot be reported as written; query for the specificity its subcategory needs.

    ReviewI50.20, I50.21, I50.22, I50.23

  2. Does the documentation support a condition named in I50.2’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewI50.4

  3. Is the underlying (etiologic) condition the Code First note names documented?
    Yes → Sequence the underlying condition first, then I50.2.
    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 I50.2. Then review the Code Also note, and 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

  • Excludes1 — check before selecting I50.2(1 note)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with I50.2: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareI50.4

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

  • Excludes2 — not part of I50.2(2 notes)

    Coding workflow: The conditions named in this note are not included in I50.2. 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 I50.2. 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

  • Code Also — related condition(1 note)

    Coding workflow: Review the related condition when both are documented and the instruction applies. A Code Also note does not fix sequencing; the order follows the circumstances of the encounter.

    ReviewI50.84

    See the official tabular notes · Guidelines I.A.17

Coding decision scenarios

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

Documentation: Both the condition I50.2 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewI50.4

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.

Don’t confuse I50.2 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of I50.2 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • I50.4— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of combined systolic (congestive) and diastolic (congestive) heart failure moves the case to I50.4; the two are not reported together unless documented as unrelated.

    Full comparison: I50.2 vs I50.4 →

  • I50.1— Specificity relationship (Review)

    Overlapping diagnoses in the same category.

    Overlapping codes in the same category — the documentation decides which is the more specific fit.

    What moves you there: A record that documents no more than “Left ventricular failure, unspecified” takes I50.1; specificity in the record moves it back here.

    Full comparison: I50.2 vs I50.1 →

  • I46— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of cardiac arrest adds I46; it is not part of this code and both may be reported when both are documented.

    Full comparison: I50.2 vs I46 →

  • P29.0— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of neonatal cardiac failure adds P29.0; it is not part of this code and both may be reported when both are documented.

    Full comparison: I50.2 vs P29.0 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Code Overview

Systolic (congestive) heart failure is a non-billable ICD-10-CM category code (I50.2). 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.

Decision Points

The directives on this code's own record, as a pre-claim checklist.

  1. Sequencing: 6 Code First instructions — the underlying condition is sequenced before this code when present. See the Code First notes
  2. 1 Code Also note — a second code may apply; the guidelines leave its sequencing to the circumstances of the encounter. See the Code Also notes
  3. 1 Excludes1 entry — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes
  4. 2 Excludes2 entries — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

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 I50.2 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 (via I50.-).

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) (via I50.-).

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 (via I50.-), I11.0 — Hypertensive heart disease with heart failure (via I50.-), 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 (via I50.-), I13.2 — Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease (via I50.-), I97.13 — Postprocedural heart failure (via I50.-).

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 (via I50.-), E83.821 — ENPP1 deficiency causing generalized arterial calcification of infancy (via I50.-), E83.823 — ABCC6 deficiency causing generalized arterial calcification of infancy (via I50.-), I16.1 — Hypertensive emergency (via I50.-).

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

Contextual Map

Every relationship of I50.2 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 I50.2 with these 13 related codes in Claim Check

Hierarchy

Excludes1

Code Also

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

Relevant guides

Common coding questions

Can I50.2 be billed directly?

No. I50.2 (Systolic (congestive) 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 FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 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

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "I50.2 — Systolic (congestive) heart failure." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/i50.2-systolic-congestive-heart-failure

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Systolic (congestive) heart failure

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, 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 I50.2 in its code family, with their registry titles.

View all codes in the I50 family