ICD-10 I50.89
Billable / Specific HCC v28: 85Other heart failure
About ICD-10-CM I50.89
ICD-10-CM code I50.89 represents Other heart failure. This is a billable/specific code in the Circulatory System chapter (block I50). The 2026 edition of ICD-10-CM I50.89 became effective on October 1, 2025.
Coding Tips for I50.89
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
I50.89 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.
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 I50.89
Local Coverage Determinations (LCDs) from CMS MACs that list I50.89 as a covered diagnosis.
Showing top 10 of 526 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing I50.89.
5 Medicare
CPT Codes Commonly Billed with I50.89
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 94762 CMS LCD: Billing and Coding: Noninvasive Ear or Pulse Oximetry For Oxygen Saturation CMS LCD
- 94760 CMS LCD: Billing and Coding: Noninvasive Ear or Pulse Oximetry For Oxygen Saturation CMS LCD
- 94761 CMS LCD: Billing and Coding: Noninvasive Ear or Pulse Oximetry For Oxygen Saturation CMS LCD
- 90999 CMS LCD: Billing and Coding: Frequency of Hemodialysis CMS LCD
- 93798 CMS LCD: Billing and Coding: Frequency and Duration for Cardiac Rehabilitation and Intensive Cardiac Rehabilitation CMS LCD
- 93797 CMS LCD: Billing and Coding: Frequency and Duration for Cardiac Rehabilitation and Intensive Cardiac Rehabilitation CMS LCD
- G0423 CMS LCD: Billing and Coding: Frequency and Duration for Cardiac Rehabilitation and Intensive Cardiac Rehabilitation CMS LCD
- G0422 CMS LCD: Billing and Coding: Frequency and Duration for Cardiac Rehabilitation and Intensive Cardiac Rehabilitation CMS LCD
Codes Adjacent To I50.89
Other codes in section I30-I5A (Other forms of heart disease).
ICD-10 I50.89, Billing FAQ
Is ICD-10 code I50.89 billable? +
Yes, I50.89 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does I50.89 affect Medicare Advantage HCC risk adjustment? +
Yes. I50.89 maps to CMS-HCC v28 category 85. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What CPT codes are commonly billed with I50.89? +
Procedures frequently paired with I50.89 include: 94762, 94760, 94761, 90999, 93798.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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