Is I50.1 a billable ICD-10-CM code?

Yes. I50.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does I50.1 sit in the tabular list?

Diseases of the circulatory system (I00-I99), in the block Other forms of heart disease (I30-I5A).

What cannot be coded together with I50.1?

I50.1 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

I50.1

I50.1 — Left ventricular failure, unspecified

Billable / specific codeICD-10-CMleft

I50.1 is a billable, specific ICD-10-CM code for left ventricular failure, unspecified. It is valid for submission on a claim.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

edema of lung without heart disease or heart failure (J81.-)
pulmonary edema without heart disease or failure (J81.-)

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

These codes carry an Excludes1 note pointing at I50.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading I50.1 alone.

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.

Medicare coverage

I50.1 is named in 64 Medicare coverage policies — 64 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A52458Automatic External Defibrillators - Policy Article
A52458Automatic External Defibrillators - Policy Article
A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography

How I50.1 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to I50.1.

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)

Related codes at this level

Codes that share I50. If I50.1 is not quite right, the correct code is usually one of these.

Questions about I50.1

Is I50.1 a billable ICD-10-CM code?: Yes. I50.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does I50.1 sit in the tabular list?: Diseases of the circulatory system (I00-I99), in the block Other forms of heart disease (I30-I5A).
What cannot be coded together with I50.1?: I50.1 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.