2026 ICD-10-CM Diagnosis Code I50.84End stage heart failure
ICD-10-CM Codes›I00–I99›I30-I5A›I50
- Billable — Valid for Submission
- Risk Adjusts — HCC 222
- Chronic Condition
I50.84 is a billable ICD-10-CM diagnosis code for end stage heart failure. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 291 through 293, 791, 793. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Heart failure.
For Medicare Advantage risk adjustment, I50.84 maps to CMS-HCC Category 222 (End Stage Heart Failure) under the V28 model, adding a risk factor of about 2.505 for a community, non-dual, aged beneficiary in payment year 2026.
This medical diagnosis code is frequently used in Cardiology medical specialties to designate conditions such heart failure.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
I50.84 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2026.
Source: CMS Payment Year 2026 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Inclusion Terms
- Stage D heart failure
Code Also
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
A "code also" note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
heart (acute) (senile) (sudden) I50.9
end stage See Also: Failure, heart, by type as diastolic or systolic, chronic; I50.84
stage D See Also: Failure, heart, by type as diastolic or systolic, chronic; I50.84
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Heart Failure
a heterogeneous condition in which the heart is unable to pump out sufficient blood to meet the metabolic need of the body. heart failure can be caused by structural defects, functional abnormalities (ventricular dysfunction), or a sudden overload beyond its capacity. chronic heart failure is more common than acute heart failure which results from sudden insult to cardiac function, such as myocardial infarction.Heart Failure, Diastolic
heart failure caused by abnormal myocardial relaxation during diastole leading to defective cardiac filling.Heart Failure, Systolic
heart failure caused by abnormal myocardial contraction during systole leading to defective cardiac emptying.Diastole
post-systolic relaxation of the heart, especially the heart ventricles.Systole
period of contraction of the heart, especially of the heart ventricles.
Patient EducationClinical
Heart Failure
Heart failure means that your heart can't pump enough oxygen-rich blood to meet your body's needs. Heart failure doesn't mean that your heart has stopped or is about to stop beating. But without enough blood flow, your organs may not work well, which can cause serious problems.
The full article covers:
- What is heart failure?
- What causes heart failure?
- Who is more likely to develop heart failure?
- What are the symptoms of heart failure?
- What other problems does heart failure cause?
- How is heart failure diagnosed?
- What are the treatments for heart failure?
- Can heart failure be prevented?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert I50.84 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code History & ChangesHistory
Replacement I50.84 replaces the following previously assigned code(s):
- I50.9 - Heart failure, unspecified
Questions About I50.84Overview
What is the ICD-10 code for end stage heart failure?
The ICD-10-CM code for end stage heart failure is I50.84 (sometimes written as I5084). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
Is I50.84 (Other heart failure) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report end stage heart failure on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does I50.84 group to?
When end stage heart failure is the principal diagnosis on an inpatient stay, it groups to MS-DRG 291, 292, 293, 791, 793, with relative weights from 0.5660 to 4.1696 depending on complications. Higher weights mean higher Medicare reimbursement.
What is the ICD-9 equivalent of I50.84?
Under the General Equivalence Mappings, end stage heart failure converts to ICD-9-CM 428.9 (heart failure NOS). The mapping is approximate, so confirm the match fits the documentation.
What HCC is I50.84?
I50.84 (end stage heart failure) maps to CMS-HCC Category 222 (End Stage Heart Failure), commonly written as HCC 222, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2026. It mapped to HCC 85 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. In the Part D prescription drug model it maps to RxHCC 186.
Does I50.84 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, I50.84 adds a risk adjustment factor of about 2.505 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.826 to 6.612 depending on the payment segment). A more severe related category (HCC 221) supersedes it when both are reported. See the full factor table on the HCC 222 category page.
