I50.1: Left ventricular failure, unspecified
I50.1 is a billable, specific ICD-10-CM code for left ventricular failure, unspecified. It is valid for submission on a claim.
Check I50.1 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Cardiac asthma
- Edema of lung with heart disease NOS
- Edema of lung with heart failure
- Left heart failure
- Pulmonary edema with heart disease NOS
- Pulmonary edema with heart failure
Other codes that can never be billed with I50.1
Their own Excludes1 notes name this code, so the conflict is not listed above.
- J81Pulmonary edema
Risk adjustment
I50.1 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 226 Heart Failure, Except End Stage and Acute0.360 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
I50.1 is named in 42 Medicare coverage policies: 42 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52458Automatic External Defibrillators - Policy Article
- A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
- A53026Billing and Coding: Bariatric Surgery Coverage
- A55354Billing and Coding: Frequency of Hemodialysis
Alphabetic index entries that lead here
- Asthma, asthmatic›cardiobronchial
- Asthma, asthmatic›heart
- Asthma, asthmatic›Rostan's
- Stone›heart syndrome
- Syndrome›cardiac asthma
- Syndrome›Ridley's
- Syndrome›stone heart
- Edema, edematous›lung›meaning failure, left ventricle
- Failure, failed›ventricular›left
- Disease, diseased›heart›with›pulmonary edema(acute)
Code history
Unchanged in every release from FY2024 to FY2027.