I50.813

I50.813: Acute on chronic right heart failure

Billable / specific codeICD-10-CMright

I50.813 is a billable, specific ICD-10-CM code for acute on chronic right heart failure. It is valid for submission on a claim.

Check I50.813 with the rest of the claim: free scrubber

Inclusion terms

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

Acute on chronic isolated right heart failure
Acute on chronic (isolated) right ventricular failure
Acute decompensation of chronic (isolated) right ventricular failure
Acute exacerbation of chronic (isolated) right ventricular failure

Excludes2 inherited from the categories above I50.813

Not part of this code, but both may be coded when both are present.

Written on I50: Heart failure

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

Risk adjustment

I50.813 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 225 Acute Heart Failure (Excludes Acute on Chronic)0.360 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

I50.813 is named in 36 Medicare coverage policies: 36 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

Failure, failed›heart›right›acute›and chronic(on)
Failure, failed›heart›right›chronic›and acute
Failure, failed›heart›with›decompensation›right

Code history

Unchanged in every release from FY2024 to FY2027.