Heart Failure ICD-10-CM codes

Category I50 distinguishes systolic heart failure (I50.2x, includes HFrEF), diastolic heart failure (I50.3x, includes HFpEF), and combined systolic and diastolic failure (I50.4x). The fifth character reports acuity: unspecified, acute, chronic, or acute on chronic.

When heart failure occurs with hypertension, the causal relationship is presumed: code I11.0 (hypertensive heart disease with heart failure) first, followed by the specific I50 code. If CKD is also present, use category I13 instead.

Documentation of ejection fraction alone is not enough to assign a systolic or diastolic code; the provider must state the type. Query when only HFrEF or HFpEF terminology is unclear.