I50.33
Acute on chronic diastolic (congestive) heart failure
I50.33 (also written I5033) is a billable ICD-10-CM diagnosis code for acute on chronic diastolic (congestive) heart failure. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 23 codes in category I50 (Heart failure). The Alphabetic Index lists it under 5 entries. Its coding notes include a Code first instruction, a Code also instruction, 1 Excludes1 entry and 12 Excludes2 entries.
Guidelines tip
From the FY2027 Official Guidelines. ICD10Ref adds no rules of its own.
Hypertension with heart failure or certain other heart conditions is assigned to category I11, with an additional code for the heart condition, unless the provider documents they are unrelated.
Code first
If the underlying condition listed here is present and known, sequence it first.
- heart failure complicating abortion or ectopic or molar pregnancy (O00-O07, O08.8)
- heart failure due to hypertension (I11.0)
- heart failure due to hypertension with chronic kidney disease (I13.-)
- heart failure following surgery (I97.13-)
- obstetric surgery and procedures (O75.4)
- rheumatic heart failure (I09.81)
Code also
Two codes may be needed to describe the condition. This note gives no sequencing order.
Excludes1
Not coded here. The listed conditions generally should not be reported together.
Excludes2
Not included here. Both codes may be reported if the patient has both conditions.
Also from chapter/block level (10 notes)
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
- systemic connective tissue disorders (M30-M36)
- transient cerebral ischemic attacks and related syndromes (G45.-)
Care settings
How CMS programs treat this code. These are CMS claim edits and list entries, not coverage or eligibility rules.
Home Health Primary
Accepted as the primary (principal) diagnosis on a home health claim. The Home Health Grouper assigns it to the MMTA - Cardiac and Circulatory clinical group.
Source: CMS Home Health Grouper Software v07.2.26, effective October 1, 2026Hospital MCC
Counts as a major complication or comorbidity (MCC) when reported as a secondary diagnosis on an inpatient claim. It does not count when the principal diagnosis is one of the 32 codes in its exclusion list. Some MS-DRGs also ignore a CC or MCC that defines the DRG.
Source: CMS MS-DRG Definitions Manual v44, effective October 1, 2026, Appendix CAlphabetic Index terms
Terms the official Alphabetic Index lists for this code. 5 entries
- Failure, failed, heart (acute) (senile) (sudden), diastolic (congestive) (left ventricular), acute (congestive), and (on) chronic (congestive)
- Failure, failed, heart (acute) (senile) (sudden), diastolic (congestive) (left ventricular), chronic (congestive), and (on) acute (congestive)
- Failure, failed, heart (acute) (senile) (sudden), with, decompensation, diastolic
- Failure, failed, heart (acute) (senile) (sudden), with, decompensation, with, normal ejection fraction
- Failure, failed, heart (acute) (senile) (sudden), with, decompensation, with, preserved ejection fraction