ICD-10 I50.84
Billable / Specific HCC v28: 85End stage heart failure
About ICD-10-CM I50.84
ICD-10-CM code I50.84 represents End stage heart failure. This is a billable/specific code in the Circulatory System chapter (block I50). The 2026 edition of ICD-10-CM I50.84 became effective on October 1, 2025.
Coding Tips for I50.84
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
I50.84 is a CMS-HCC v28 risk-adjustment code (category 85). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under I50.84. Per CMS ICD-10-CM Tabular 2026.
- Stage D heart failure
Coding Notes
Code Also
- the type of heart failure as systolic, diastolic, or combined, if known (I50.2-I50.43)
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Medicare LCD Coverage for I50.84
Local Coverage Determinations (LCDs) from CMS MACs that list I50.84 as a covered diagnosis.
Showing top 10 of 558 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing I50.84.
2 Cigna
5 Medicare
CPT Codes Commonly Billed with I50.84
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- G0448 CMS LCD: Billing and Coding: Implantable Automatic Defibrillators CMS LCD
- 33216 CMS LCD: Billing and Coding: Implantable Automatic Defibrillators CMS LCD
- 33230 CMS LCD: Billing and Coding: Implantable Automatic Defibrillators CMS LCD
- 33244 CMS LCD: Billing and Coding: Implantable Automatic Defibrillators CMS LCD
- 33264 CMS LCD: Billing and Coding: Implantable Automatic Defibrillators CMS LCD
- 33263 CMS LCD: Billing and Coding: Implantable Automatic Defibrillators CMS LCD
- 33220 CMS LCD: Billing and Coding: Implantable Automatic Defibrillators CMS LCD
- 33224 CMS LCD: Billing and Coding: Implantable Automatic Defibrillators CMS LCD
- 33270 CMS LCD: Billing and Coding: Implantable Automatic Defibrillators CMS LCD
- 33272 CMS LCD: Billing and Coding: Implantable Automatic Defibrillators CMS LCD
Codes Adjacent To I50.84
Other codes in section I30-I5A (Other forms of heart disease).
ICD-10 I50.84, Billing FAQ
Is ICD-10 code I50.84 billable? +
Yes, I50.84 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What other names or terms map to I50.84? +
ICD-10 I50.84 includes: Stage D heart failure.
Does I50.84 affect Medicare Advantage HCC risk adjustment? +
Yes. I50.84 maps to CMS-HCC v28 category 85. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What CPT codes are commonly billed with I50.84? +
Procedures frequently paired with I50.84 include: G0448, 33216, 33230, 33244, 33264.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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