Alphabetic Index FY2027

I50.4

Combined systolic (congestive) and diastolic (congestive) heart failure

FY2027Chapter 9: Diseases of the circulatory system/I30–I5A Other forms of heart disease

Non-billable headerNot valid on its own. Use one of the more specific codes under it.

I50.4 is a non-billable ICD-10-CM code header for combined systolic (congestive) and diastolic (congestive) heart failure. Report a more specific code from it instead. It is part of the FY2027 code set, effective October 1, 2026. The more specific codes under it are I50.40 Unspecified combined systolic (congestive) and diastolic (congestive) heart failure, I50.41 Acute combined systolic (congestive) and diastolic (congestive) heart failure, I50.42 Chronic combined systolic (congestive) and diastolic (congestive) heart failure and I50.43 Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure. Its coding notes include a Code first instruction, a Code also instruction 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.

Guidelines I.C.9.a.1Hypertension with heart diseaseRead the official text

Code first

If the underlying condition listed here is present and known, sequence it first.

Inherited from I50 Heart failure
  • 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.

This code
  • end stage heart failure, if applicable (I50.84)

Excludes2

Not included here. Both codes may be reported if the patient has both conditions.

Inherited from I50 Heart failure
  • cardiac arrest (I46.-)
  • neonatal cardiac failure (P29.0)
Also from chapter/block level (10 notes)
Inherited from Chapter 9 Diseases of the circulatory system
  • 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.-)

Inclusion terms

Conditions classified to this code.

This code
  • Combined systolic and diastolic left ventricular heart failure
  • Heart failure with reduced ejection fraction and diastolic dysfunction

More specific codes under I50.4 4