I50.40 — Unspecified combined systolic (congestive) and diastolic (congestive) heart failure
I50.40 is a billable, specific ICD-10-CM code for unspecified combined systolic (congestive) and diastolic (congestive) heart failure. It is valid for submission on a claim.
Risk adjustment
I50.40 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
I50.40 is named in 46 Medicare coverage policies — 46 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 I50.40 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 I50.40.
- Failure, failed›heart›diastolic›combined with systolic(congestive)
- Failure, failed›Note: heart failure stages A, B, C, and D are based on the American College of Cardiology and American Heart Association stages of heart failure, which complement and should not be confused with the New York Heart Association Classification of Heart Failure, into Class I, Class II, Class III, and Class IV›systolic›combined with diastolic(congestive)
Related codes at this level
Codes that share I50.4. If I50.40 is not quite right, the correct code is usually one of these.
Questions about I50.40
- Is I50.40 a billable ICD-10-CM code?
- Yes. I50.40 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does I50.40 sit in the tabular list?
- Diseases of the circulatory system (I00-I99), in the block Other forms of heart disease (I30-I5A).