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I50.81 ICD-10-CM Code: Right 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
1 inclusion term · 2 Excludes2 · 6 code-first instructions

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for I50.81 in the official ICD-10-CM tabular list, quoted as published.

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

Notes without a marker are published on I50.81 itself; “inherited from” names the category or block whose note applies here.

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Right ventricular failure

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

Coder workflow for I50.81

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

Before you code I50.81

  1. I50.81 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).

    ReviewI50.810, I50.811, I50.812, I50.813, I50.814

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

  2. Laterality is coded in this family. Confirm the side documented — right, left, or bilateral — and select the matching code (this page’s code: right). The unspecified-side code applies only when the record states no side. Laterality is assigned from the documented side; where a bilateral code exists and both sides are documented, it is used instead of two unilateral codes (Guidelines I.B.13).

    See the relationships section · Guide: Laterality coding →

Choose the right path

  1. Does the documentation support one of the more specific codes beneath I50.81?
    Yes → Select that code and continue the checks below on its own page.
    No → I50.81 cannot be reported as written; query for the specificity its subcategory needs.

    ReviewI50.810, I50.811, I50.812, I50.813, I50.814

  2. Is the underlying (etiologic) condition the Code First note names documented?
    Yes → Sequence the underlying condition first, then I50.81.
    No → Continue; do not add an underlying condition the record does not document.

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

  3. Is the side documented?
    Yes → Select the code for the documented side (or the bilateral code when both sides are documented and one exists).
    No → Use the unspecified-side code only when the record states no side; a query is the alternative.

Consider I50.81. 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).
Laterality
Right, left or bilateral as documented; unspecified only when the record states no side (Guidelines I.B.13).
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 I50.81(2 notes)

    Coding workflow: The conditions named in this note are not included in I50.81. 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 I50.81. 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 record documents the condition on one side only.

Coding question: Which code in this family applies?

Path: Select the sibling code for the documented side.

Reason: Laterality is assigned from the documented side; the unspecified-side code is for records that state no side (Guidelines I.B.13).

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

Right heart failure is a non-billable ICD-10-CM category code (I50.81). 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. Laterality is coded in this family. Confirm the documented side matches the code — the opposite-side siblings are in the relationships section. See the opposite-side sibling codes
  2. Sequencing: 6 Code First instructions — the underlying condition is sequenced before this code when present. See the Code First notes
  3. 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 I50.81 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 5 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.-), I27.81 — Cor pulmonale (chronic).

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

Contextual Map

Every relationship of I50.81 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 I50.81 with these 12 related codes in Claim Check

Hierarchy

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

Common coding questions

Can I50.81 be billed directly?

No. I50.81 (Right 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
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

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. "I50.81 — Right heart failure." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/i50.81-right-heart-failure

Change history

  • FY2018 — October 1, 2017
    Added to the code set
    Right heart failure
    FY2018 changes

Nearest Codes in This Family

Official ICD-10-CM classifications closest to I50.81 in its code family, with their registry titles.

View all codes in the I50 family