ICD10BillableValid for clinical use
ICD-10 Code I50.40: Unspecified combined systolic (congestive) and diastolic (congestive) heart failure
Reviewed by HealthAssure Clinical TeamUpdated 26 May 2026
What is this code?
ICD-10 codes are diagnosis classification codes used in healthcare records, reporting, coding workflows, and billing support. This code sits within the broader ICD-10 area for Diseases of the circulatory system (I00-I99).
đź“‹Clinical overview
This ICD-10 code is commonly used when documentation describes heart failure or impaired cardiac pumping function. The most accurate code depends on whether the record identifies the heart-failure type, side, acuity, or ejection-fraction context.
When is it used?
- May be used when a clinician documents unspecified combined systolic (congestive) and diastolic (congestive) heart failure in a patient's medical record.
- May appear in hospital records, claims, referrals, and clinical documentation.
- This code can be used as a clinically usable diagnosis entry in standardized coding workflows.
What it does not mean
- A code alone does not explain severity, treatment plan, or outcome.
- A medical code should not be treated as a substitute for a doctor's diagnosis or advice.
đź©şClinical context
When commonly used
- Emergency, inpatient, cardiology, and chronic-disease documentation where fluid overload, reduced cardiac function, or decompensation is part of the active problem list.
- Risk-adjustment, utilization-review, and follow-up workflows where heart-failure specificity affects longitudinal care planning and treatment review.
Common management context
- Heart-failure follow-up often includes symptom review, volume-status assessment, medication reconciliation, cardiac imaging context, and monitoring for worsening congestion or reduced function.
- Documentation usually becomes more specific when the chart identifies systolic or diastolic dysfunction, acute versus chronic status, left or right-sided failure, or reduced ejection fraction.
- Specialist context already linked on this page includes Cardiologist, General Physician, ENT Specialist.
🔍Key distinctions
Important notes
- ICD-10 heart-failure coding is often more specific when the record identifies acute, chronic, combined, systolic, diastolic, or side-specific heart failure detail.
- Heart failure may coexist with hypertension, valvular disease, kidney disease, arrhythmia, or ischemic disease, but related conditions may still require their own linked codes.
- This title reflects broad heart-failure language; if the chart clearly identifies acute, chronic, systolic, diastolic, or side-specific failure, a more specific code may be used.
- Congestive heart failure documentation often signals fluid-overload context, but code selection may still depend on whether the record identifies acute versus chronic or systolic versus diastolic detail.
Related codes to consider
I50.41Acute combined systolic (congestive) and diastolic (congestive) heart failure
Related heart-failure ICD-10 code; documentation often becomes more specific when the chart identifies acuity, systolic/diastolic type, or side-specific failure detail.
I50.42Chronic combined systolic (congestive) and diastolic (congestive) heart failure
Related heart-failure ICD-10 code; documentation often becomes more specific when the chart identifies acuity, systolic/diastolic type, or side-specific failure detail.
I50.43Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure
Related heart-failure ICD-10 code; documentation often becomes more specific when the chart identifies acuity, systolic/diastolic type, or side-specific failure detail.
Code hierarchy
chapter
9Diseases of the circulatory system (I00-I99)
block
I30-I5AOther forms of heart disease
category
I50Heart failure
category
I50.4Combined systolic (congestive) and diastolic (congestive) heart failure
currentI50.4
Where you may see this code
You may see this code in hospital records, discharge summaries, insurance claims, encounter documentation, referrals, or other healthcare billing and coding records.
Related specialists
CardiologistGeneral PhysicianENT Specialist
Related codes
Sibling codes
Coverage-related procedures and services
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Source: CMS coverage guidance
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Source: CMS coverage guidance
CPT 81418high
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Source: CMS coverage guidance
CPT 0349Uhigh
DRUG METABOLISM OR PROCESSING (MULTIPLE CONDITIONS), WHOLE BLOOD OR BUCCAL SPECIMEN, DNA ANALYSIS, 27 GENE REPORT, WITH VARIANT ANALYSIS, INCLUDING REPORTED PHENOTYPES AND IMPACTED GENE-DRUG INTERACTIONS
Source: CMS coverage guidance
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Source: CMS coverage guidance
Coding guidelines
Common synonyms
Unspecified combined systolic (congestive) and diastolic (congestive) heart failureUnspecified combined systolicUnspecified combined systolic congestive and diastolic congestive heart failure
Frequently asked questions
About this content
This page is prepared by HealthAssure's clinical team using official coding standards from ICD-10. AI tools assist with drafting explanations, which are then reviewed and verified by healthcare professionals for accuracy. This content is for informational purposes and does not replace professional medical advice. Meet our team.