Is I50.4 a billable ICD-10-CM code?

No. I50.4 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does I50.4 sit in the tabular list?

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

I50.4

I50.4 — Combined systolic (congestive) and diastolic (congestive) heart failure

Non-billable headerICD-10-CM

I50.4 is a non-billable header ICD-10-CM code for combined systolic (congestive) and diastolic (congestive) heart failure. It cannot be billed on its own: choose one of the more specific child codes below.

Code also

Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.

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

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Combined systolic and diastolic left ventricular heart failure
Heart failure with reduced ejection fraction and diastolic dysfunction

Excludes2 inherited from the categories above I50.4

Also inherited, and the opposite of Excludes1: these conditions are not part of I50.4, but a patient can have both, so you may code both.

Written on I50 — Heart failure

cardiac arrest (I46.-)
neonatal cardiac failure (P29.0)

Other codes that can never be billed with I50.4

These codes carry an Excludes1 note pointing at I50.4. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading I50.4 alone.

I50.2Systolic (congestive) heart failure
I50.3Diastolic (congestive) heart failure

Risk adjustment

I50.4 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Code history

I50.4 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Code to one of these instead I50.4

4 child codes. Green means billable.

Related codes at this level

Codes that share I50. If I50.4 is not quite right, the correct code is usually one of these.

Questions about I50.4

Is I50.4 a billable ICD-10-CM code?: No. I50.4 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does I50.4 sit in the tabular list?: Diseases of the circulatory system (I00-I99), in the block Other forms of heart disease (I30-I5A).