ICD-10 · PDGM grouping
I50 Heart failure
All 23 codes in the I50 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
Codes in family
23
Can lead a claim
23
Cannot lead a claim
0
What CMS assigns to I50
All 23 codes group to MMTA - Cardiac and Circulatory. All 23 count toward the Heart Failure comorbidity subgroup. Every code can lead a claim. CMS attaches a code-first note to all 23.
- Heart Failure: can award the low comorbidity tier as a secondary diagnosis.
Code first
CMS grouper convention 72, on all 23 codes. Code 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)
Every code in I50
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| I50.1 | Left ventricular failure, unspecified | Can lead a claim, code first applies | H | Heart Failure |
| I50.2 Systolic (congestive) heart failure | ||||
| I50.20 | Unspecified systolic (congestive) heart failure | Can lead a claim, code first applies | H | Heart Failure |
| I50.21 | Acute systolic (congestive) heart failure | Can lead a claim, code first applies | H | Heart Failure |
| I50.22 | Chronic systolic (congestive) heart failure | Can lead a claim, code first applies | H | Heart Failure |
| I50.23 | Acute on chronic systolic (congestive) heart failure | Can lead a claim, code first applies | H | Heart Failure |
| I50.3 Diastolic (congestive) heart failure | ||||
| I50.30 | Unspecified diastolic (congestive) heart failure | Can lead a claim, code first applies | H | Heart Failure |
| I50.31 | Acute diastolic (congestive) heart failure | Can lead a claim, code first applies | H | Heart Failure |
| I50.32 | Chronic diastolic (congestive) heart failure | Can lead a claim, code first applies | H | Heart Failure |
| I50.33 | Acute on chronic diastolic (congestive) heart failure | Can lead a claim, code first applies | H | Heart Failure |
| I50.4 Combined systolic (congestive) and diastolic (congestive) heart failure | ||||
| I50.40 | Unspecified combined systolic (congestive) and diastolic (congestive) heart failureCMS: Unsp combined systolic and diastolic (congestive) hrt fail | Can lead a claim, code first applies | H | Heart Failure |
| I50.41 | Acute combined systolic (congestive) and diastolic (congestive) heart failureCMS: Acute combined systolic and diastolic (congestive) hrt fail | Can lead a claim, code first applies | H | Heart Failure |
| I50.42 | Chronic combined systolic (congestive) and diastolic (congestive) heart failureCMS: Chronic combined systolic and diastolic hrt fail | Can lead a claim, code first applies | H | Heart Failure |
| I50.43 | Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failureCMS: Acute on chronic combined systolic and diastolic hrt fail | Can lead a claim, code first applies | H | Heart Failure |
| I50.8 Other heart failure | ||||
| I50.81 Right heart failure | ||||
| I50.810 | Right heart failure, unspecified | Can lead a claim, code first applies | H | Heart Failure |
| I50.811 | Acute right heart failure | Can lead a claim, code first applies | H | Heart Failure |
| I50.812 | Chronic right heart failure | Can lead a claim, code first applies | H | Heart Failure |
| I50.813 | Acute on chronic right heart failure | Can lead a claim, code first applies | H | Heart Failure |
| I50.814 | Right heart failure due to left heart failure | Can lead a claim, code first applies | H | Heart Failure |
| I50.82 | Biventricular heart failure | Can lead a claim, code first applies | H | Heart Failure |
| I50.83 | High output heart failure | Can lead a claim, code first applies | H | Heart Failure |
| I50.84 | End stage heart failure | Can lead a claim, code first applies | H | Heart Failure |
| I50.89 | Other heart failure | Can lead a claim, code first applies | H | Heart Failure |
| I50.9 | Heart failure, unspecified | Can lead a claim, code first applies | H | Heart Failure |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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