I50.43

Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure

Billable FY2026 2025-10-01 → 2026-09-30

Exclusions 12 never code together

I50code

Excludes2

cardiac arrest (I46.-)I46.-
neonatal cardiac failure (P29.0)P29.0

I00-I99chapter

Excludes2

certain conditions originating in the perinatal period (P04-P96)P04-P96
certain infectious and parasitic diseases (A00-B99)A00-B99
complications of pregnancy, childbirth and the puerperium (O00-O9A)O00-O9A
congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)Q00-Q99
endocrine, nutritional and metabolic diseases (E00-E88)E00-E88
injury, poisoning and certain other consequences of external causes (S00-T88)S00-T88
neoplasms (C00-D49)C00-D49
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)R00-R94
systemic connective tissue disorders (M30-M36)M30-M36
transient cerebral ischemic attacks and related syndromes (G45.-)G45.-

Excludes2 — not included here, but the patient may have both. Code both when documented.

Instructional notes 9

I50.4code

Inclusion terms

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

Code also

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

I50code

Code first

heart failure complicating abortion or ectopic or molar pregnancy (O00-O07, O08.8)O00-O07 O08.8
heart failure due to hypertension (I11.0)I11.0
heart failure due to hypertension with chronic kidney disease (I13.-)I13.-
heart failure following surgery (I97.13-)I97.13-
obstetric surgery and procedures (O75.4)O75.4
rheumatic heart failure (I09.81)I09.81

Index entries leading here 1

Failure, failed
- heart (acute) (senile) (sudden) I50.9
  - diastolic (congestive) (left ventricular) I50.30
    - combined with systolic (congestive) I50.40
      - acute (congestive) I50.41
        
        and (on) chronic (congestive) I50.43
      - chronic (congestive) I50.42
        
        and (on) acute (congestive) I50.43
  - with
    - decompensation I50.9
      - combined systolic and diastolic I50.43
      - with
        
        reduced ejection fraction I50.23
        
        with diastolic dysfunction I50.43
- 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
  - systolic (congestive) (left ventricular) I50.20
    - combined with diastolic (congestive) I50.40
      - acute (congestive) I50.41
        
        and (on) chronic (congestive) I50.43
      - chronic (congestive) I50.42
        
        and (on) acute (congestive) I50.43

Alongside this code 3 same parent — I50.4

I50.40 Unsp combined systolic and diastolic (congestive) hrt fail I50.41 Acute combined systolic and diastolic (congestive) hrt fail I50.42 Chronic combined systolic and diastolic hrt fail

Medications 4

1 Heart Failure, Systolic drugs 246 Heart Failure drugs 29 Kidney Failure, Chronic drugs 1 Chemical and Drug Induced Liver Injury, Chronic drugs

MED-RT files conditions by MeSH, which carves the world differently from ICD-10. These are name matches on this code's description, offered as candidates — not as an assertion that they are this code.

Additional references

AHA Coding Clinic® Licence required

Official coding advice for this code. Published by the American Hospital Association. Not included in this installation.

Risk adjustment

CMS22HCC85 CMS28HCC224 ESRD21HCC85 ESRD24HCC85 RX08HCC186

Presence is a property of the code. Untick a model to hide it everywhere.

This code

Billable: yes
Code set: FY2026
Parent: I50.4
Block: I30-I5A
Siblings: 3

Present FY2024–FY2027.