I50.84: End stage heart failure
I50.84 is a billable, specific ICD-10-CM code for end stage heart failure. It is valid for submission on a claim.
Check I50.84 with the rest of the claim: free scrubberCode also
Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Stage D heart failure
Risk adjustment
I50.84 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 222 End Stage Heart Failure2.505 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
I50.84 is named in 39 Medicare coverage policies: 39 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
- A53026Billing and Coding: Bariatric Surgery Coverage
- A53775Billing and Coding: Frequency and Duration for Cardiac Rehabilitation and Intensive Cardiac Rehabilitation
- A55354Billing and Coding: Frequency of Hemodialysis
Alphabetic index entries that lead here
- Failure, failed›heart›end stage
- 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›stage D
Code history
Unchanged in every release from FY2024 to FY2027.