I50.89 ICD-10-CM Code: Other heart failure

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for I50.89 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 I50.89 itself; “inherited from” names the category or block whose note applies here.

Coder workflow for I50.89

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

Before you code I50.89

1. “Other” (NEC) means the condition is specified in the record but no dedicated code captures it. Confirm the documented form is not one a sibling code names before settling on I50.89; if the record states no specifics at all, the unspecified sibling applies instead. “Other” codes are for documented conditions the classification gives no specific code; “unspecified” codes are for records lacking the detail (Guidelines I.A.9.a, I.A.9.b).

   ReviewI50.81, I50.82, I50.83, I50.84

   See the relationships section · Guide: Other vs unspecified (NEC vs NOS) →

Choose the right path

1. Is the underlying (etiologic) condition the Code First note names documented?
   Yes → Sequence the underlying condition first, then I50.89.
   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 I50.89. 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).

Any detail beyond this code’s title

What the record states that a more specific sibling code would capture — or its absence, which itself supports the unspecified code.

Official instructions as workflow

• Excludes2 — not part of I50.89(2 notes)

  Coding workflow: The conditions named in this note are not included in I50.89. 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 I50.89. 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

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.

Indexed Clinical Terms (1)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

• Failure, failed, heart (acute) (senile) (sudden), specified NEC

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.

Don’t confuse I50.89 with…

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

The codes most likely to be picked instead of I50.89 — 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.

• 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: I50.89 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: I50.89 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.

Verify Before Coding

• No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

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 I50.89 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.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 5 MS-DRGs: DRG 291 (MDC 05), DRG 292 (MDC 05), DRG 293 (MDC 05), DRG 791 (MDC 15), DRG 793 (MDC 15).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):CIR019 — Heart failure (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Heart Failure, Except End-Stage and Acute) for risk-adjusted payment.

I27.83 — Eisenmenger's syndrome, I27.89 — Other specified pulmonary heart diseases, I27.9 — Pulmonary heart disease, unspecified, I28.0 — Arteriovenous fistula of pulmonary vessels, I28.1 — Aneurysm of pulmonary artery, I28.8 — Other diseases of pulmonary vessels, I28.9 — Disease of pulmonary vessels, unspecified, I50.1 — Left ventricular failure, unspecified, I50.20 — Unspecified systolic (congestive) heart failure, I50.22 — Chronic systolic (congestive) heart failure, I50.30 — Unspecified diastolic (congestive) heart failure, I50.32 — Chronic diastolic (congestive) heart failure, I50.40 — Unspecified combined systolic (congestive) and diastolic (congestive) heart failure, I50.42 — Chronic combined systolic (congestive) and diastolic (congestive) heart failure, I50.810 — Right heart failure, unspecified, I50.812 — Chronic right heart failure, I50.814 — Right heart failure due to left heart failure, I50.82 — Biventricular heart failure, I50.83 — High output heart failure, I50.9 — Heart failure, unspecified, +13 more

Related risk categories

These categories interact through CMS's HCC hierarchy — one can suppress the other's risk-adjustment weight when both are present on a claim.

Heart Failure with Heart Assist Device/Artificial Heart, Acute on Chronic Heart Failure, Acute Heart Failure (Excludes Acute on Chronic), Cardiomyopathy/Myocarditis

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Heart failure).

I50.41 — Acute combined systolic (congestive) and diastolic (congestive) heart failure, I50.42 — Chronic combined systolic (congestive) and diastolic (congestive) heart failure, I50.43 — Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure, I50.810 — Right heart failure, unspecified, I50.811 — Acute right heart failure, I50.812 — Chronic right heart failure, I50.813 — Acute on chronic right heart failure, I50.814 — Right heart failure due to left heart failure, I50.82 — Biventricular heart failure, I50.83 — High output heart failure, I50.84 — End stage heart failure, I50.9 — Heart failure, unspecified, I97.130 — Postprocedural heart failure following cardiac surgery, I97.131 — Postprocedural heart failure following other surgery, O29.121 — Cardiac failure due to anesthesia during pregnancy, first trimester, O29.122 — Cardiac failure due to anesthesia during pregnancy, second trimester, O29.123 — Cardiac failure due to anesthesia during pregnancy, third trimester, O29.129 — Cardiac failure due to anesthesia during pregnancy, unspecified trimester, Z95.811 — Presence of heart assist device, Z95.812 — Presence of fully implantable artificial heart, +14 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Failure, failed”; these codes share that main term but sit in a different category of the Tabular List.

G93.89 — Other specified disorders of brain (respiration, respiratory, center), I01.8 — Other acute rheumatic heart disease (ventricular, left, rheumatic, active or acute), I02.0 — Rheumatic chorea with heart involvement (ventricular, left, rheumatic, active or acute, with chorea), I05.8 — Other rheumatic mitral valve diseases (mitral), I06.8 — Other rheumatic aortic valve diseases (aortic, rheumatic), I09.81 — Rheumatic heart failure (heart, congestive, rheumatic), I09.9 — Rheumatic heart disease, unspecified (heart, rheumatic), I12.0 — Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease (renal, end stage, due to hypertension), I13.2 — Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease (cardiorenal, hypertensive), I35.8 — Other nonrheumatic aortic valve disorders (aortic), I67.9 — Cerebrovascular disease, unspecified (cerebrovascular), I70.90 — Unspecified atherosclerosis (heart, arteriosclerotic), I97.13 — Postprocedural heart failure (heart, postprocedural), I97.130 — Postprocedural heart failure following cardiac surgery (heart, following cardiac surgery), I97.131 — Postprocedural heart failure following other surgery (heart, following other surgery), J95.821 — Acute postprocedural respiratory failure (respiration, respiratory, postprocedural), J95.822 — Acute and chronic postprocedural respiratory failure (respiration, respiratory, postprocedural, acute and chronic), J96.00 — Acute respiratory failure, unspecified whether with hypoxia or hypercapnia (respiration, respiratory, acute), J96.01 — Acute respiratory failure with hypoxia (respiration, respiratory, acute, with, hypoxia), J96.02 — Acute respiratory failure with hypercapnia (respiration, respiratory, acute, with, hypercarbia), +108 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Blood Glucose Test, Gamma-glutamyl Transferase (GGT) Test, Lipid Panel, Thyroid Stimulating Hormone (TSH)

Contextual Map

Every relationship of I50.89 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 I50.89 with these 11 related codes in Claim Check

Hierarchy

• I00-I99 — Chapter 9: Diseases of the Circulatory System (I00-I99) (I00-I99)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• I30-I5A — Other forms of heart disease[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Referenced by Excludes2 notes

• J91 — Pleural effusion in conditions classified elsewhere[Excludes2](via I50.-): “pleural effusion in heart failure (I50.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Code First instructions

• I5A — Non-ischemic myocardial injury (non-traumatic)[Code First](via I50.-): “heart failure (I50.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Use Additional Code instructions

• I09.81 — Rheumatic heart failure[Use Additional Code](via I50.-): “code to identify type of heart failure (I50.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• I11.0 — Hypertensive heart disease with heart failure[Use Additional Code](via I50.-): “code to identify type of heart failure (I50.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• 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[Use Additional Code](via I50.-): “code to identify type of heart failure (I50.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• I13.2 — Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease[Use Additional Code](via I50.-): “code to identify type of heart failure (I50.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• I97.13 — Postprocedural heart failure[Use Additional Code](via I50.-): “code to identify the heart failure (I50.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Code Also instructions

• E83.820 — Generalized arterial calcification of infancy with unspecified genetic causality[Code Also](via I50.-): “heart failure (I50.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• E83.821 — ENPP1 deficiency causing generalized arterial calcification of infancy[Code Also](via I50.-): “heart failure (I50.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• E83.823 — ABCC6 deficiency causing generalized arterial calcification of infancy[Code Also](via I50.-): “heart failure (I50.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• I16.1 — Hypertensive emergency[Code Also](via I50.-): “acute pulmonary edema (left and/or right ventricular failure) (J81.0, I50.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Clinical classification (CCSR)

• CIR019 — Heart failure[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)

Risk adjustment (CMS-HCC)

• HCC 226 — Heart Failure, Except End-Stage and Acute [CMS-HCC]: “Heart Failure, Except End-Stage and Acute — supersedes HCC 227 (Cardiomyopathy/Myocarditis)”— CMS-HCC V28 · 2026

MS-DRG Grouper

• DRG 291 — HEART FAILURE AND SHOCK WITH MCC[MS-DRG]: “HEART FAILURE AND SHOCK WITH MCC (MDC 05)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 292 — HEART FAILURE AND SHOCK WITH CC[MS-DRG]: “HEART FAILURE AND SHOCK WITH CC (MDC 05)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 293 — HEART FAILURE AND SHOCK WITHOUT CC/MCC[MS-DRG]: “HEART FAILURE AND SHOCK WITHOUT CC/MCC (MDC 05)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 791 — PREMATURITY WITH MAJOR PROBLEMS[MS-DRG]: “PREMATURITY WITH MAJOR PROBLEMS (MDC 15)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS[MS-DRG]: “FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026

MDC crossing

• MDC 05 — Diseases and Disorders of the Circulatory System[MDC crossing]: “Diseases and Disorders of the Circulatory System — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 17,209 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026
• MDC 15 — Newborns and Other Neonates with Conditions Originating in Perinatal Period[MDC crossing]: “Newborns and Other Neonates with Conditions Originating in Perinatal Period — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

• Failure, failed, heart (acute) (senile) (sudden), specified NEC[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (28)

• I50 — Heart failure[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• I50.1 — Left ventricular failure, unspecified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• I50.2 — Systolic (congestive) heart failure[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• I50.20 — Unspecified systolic (congestive) heart failure[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• I50.21 — Acute systolic (congestive) heart failure[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• I50.22 — Chronic systolic (congestive) heart failure[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• I50.23 — Acute on chronic systolic (congestive) heart failure[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• I50.3 — Diastolic (congestive) heart failure[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• and 20 more

Change history

• FY2018 — Added to the code set[Change history]— CMS release files (code change ledger) · icd10cm-fy2018

Relevant guides

• How Do I Code Heart Failure? Type, Acuity, and the Hypertension Combination Codes →

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

Inpatient payment groups Official source data

CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page

Risk adjustment Official source data

2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release 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

Nearest Codes in This Family

Official ICD-10-CM classifications closest to I50.89 in its code family, with their registry titles.

• I50.81 — Right heart failure
• I50.810 — Right heart failure, unspecified
• I50.811 — Acute right heart failure
• I50.812 — Chronic right heart failure
• I50.813 — Acute on chronic right heart failure
• I50.814 — Right heart failure due to left heart failure
• I50.82 — Biventricular heart failure
• I50.83 — High output heart failure
• I50.84 — End stage heart failure
• I50.9 — Heart failure, unspecified

View all codes in the I50 family