I50.9 — Heart failure, unspecified
I50.9 is a billable, specific ICD-10-CM code for heart failure, unspecified. It is valid for submission on a claim.
Excludes2 — not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
- fluid overload unrelated to congestive heart failure (E87.70)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Cardiac, heart or myocardial failure NOS
- Congestive heart disease
- Congestive heart failure NOS
Risk adjustment
I50.9 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
I50.9 is named in 49 Medicare coverage policies — 49 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 I50.9 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 I50.9.
- Asthenia, asthenic›cardiac
- Asthenia, asthenic›cardiovascular
- Asthenia, asthenic›heart
- Asthenia, asthenic›myocardial
- Failure, failed›cardiorenal(chronic)
- Failure, failed›heart(acute) (senile) (sudden)
- Failure, failed›myocardial, myocardium
- Failure, failed›ventricular
- Insufficiency, insufficient›myocardial, myocardium(with arteriosclerosis)
- Paralysis, paralytic›cardiac
- Dysfunction›ventricular›with congestive heart failure
- Failure, failed›heart›compensated
Related codes at this level
Codes that share I50. If I50.9 is not quite right, the correct code is usually one of these.
Questions about I50.9
- Is I50.9 a billable ICD-10-CM code?
- Yes. I50.9 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does I50.9 sit in the tabular list?
- Diseases of the circulatory system (I00-I99), in the block Other forms of heart disease (I30-I5A).