ICD-10-CM 2027 diagnosis code
I50.41Acute combined systolic (congestive) and diastolic (congestive) heart failure
I50.41 is a valid, billable ICD-10-CM code for acute combined systolic (congestive) and diastolic (congestive) heart failure. It can be reported on claims for dates of service from October 1, 2026 – September 30, 2027.Short description: Acute combined systolic and diastolic (congestive) hrt fail
Code unchanged since ICD-10-CM took effect on October 1, 2015. Source: official FY2027 ICD-10-CM release from CDC/NCHS and CMS. Page updated September 29, 2026. About our data
About I50.41
I50.41 is the ICD-10-CM diagnosis code for acute combined systolic (congestive) and diastolic (congestive) heart failure. It belongs to category I50 (heart failure), block I30-I5A (other forms of heart disease) and chapter 9 (diseases of the circulatory system). It is billable, so it can be reported on its own for dates of service from October 1, 2026 through September 30, 2027.
Within I50.4 (combined systolic (congestive) and diastolic (congestive) heart failure), I50.41 is specifically for acute combined systolic (congestive) and diastolic (congestive) heart failure. Related codes cover unspecified combined systolic (congestive) and diastolic (congestive) heart failure (I50.40), chronic combined systolic (congestive) and diastolic (congestive) heart failure (I50.42) and acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure (I50.43).
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-) and 2 more.
As a secondary diagnosis it is an MCC (major complication or comorbidity), which can move an inpatient stay into the highest-paying "with MCC" MS-DRG of its family, unless the principal diagnosis excludes it.
In MS-DRG v44.0, it is part of the grouping logic for DRG 291 (Heart Failure and Shock with MCC, relative weight 1.2685), DRG 292 (Heart Failure and Shock with CC, relative weight 0.8616), DRG 293 (Heart Failure and Shock without CC/MCC, relative weight 0.5462), DRG 791 (Prematurity with Major Problems, relative weight 4.1075) and DRG 793 (Full Term Neonate with Major Problems, relative weight 4.2195), in MDC 05 (Diseases and Disorders of the Circulatory System) and MDC 15 (Newborns and Other Neonates with Conditions Originating in the Perinatal Period), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.
It has been part of ICD-10-CM since the code set took effect on October 1, 2015 and hasn't changed since.
Before ICD-10, this condition was coded in ICD-9-CM as 428.0 (congestive heart failure, unspecified), 428.41 (acute combined systolic and diastolic heart failure) and 428.41 (acute combined systolic and diastolic heart failure).
Notes that apply from higher levels
Instructions written at a parent level also apply to I50.41.
› From I50.4 Combined systolic (congestive) and diastolic (congestive) heart failure
- end stage heart failure, if applicable (I50.84)
› From I50 Heart failure
- 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)
Broader instructions also apply from Chapter 9: Diseases of the circulatory system.
Alphabetic index entries
2 entriesTerms in the official ICD-10-CM index that lead to I50.41.
- Failure, failed › heart (acute) (senile) (sudden) › diastolic (congestive) (left ventricular) › combined with systolic (congestive) › acute (congestive)
- Failure, failed › Note: heart failure stages A, B, C, and D are based on the American College of Cardiology and American Heart Association stages of heart failure, which complement and should not be confused with the New York Heart Association Classification of Heart Failure, into Class I, Class II, Class III, and Class IV › systolic (congestive) (left ventricular) › combined with diastolic (congestive) › acute (congestive)
MS-DRG v44.0 grouping
All DRGs →Inpatient MS-DRGs this diagnosis can group to, as the principal or a secondary diagnosis, depending on the rest of the claim.
MDC 05 · Diseases and Disorders of the Circulatory System
MDC 15 · Newborns and Other Neonates with Conditions Originating in the Perinatal Period
MDC 15 · Newborns and Other Neonates with Conditions Originating in the Perinatal Period
ICD-9-CM equivalent
Converter →- 428.0Congestive heart failure, unspecifiedapproximate, combination
- 428.41Acute combined systolic and diastolic heart failureapproximate
- 428.41Acute combined systolic and diastolic heart failureapproximate, combination
From the CMS 2018 General Equivalence Mappings (GEMs), the final GEMs release.
Code history
- 2016
- 2017
- 2018
- 2019
- 2020
- 2021
- 2022
- 2023
- 2024
- 2025
- 2026
- 2027
- FY2016 (effective 10/1/2015): Added (first year of ICD-10-CM)
- No changes since FY2016.
Common questions about I50.41
Is I50.41 billable?
- Yes. I50.41 is a billable/specific ICD-10-CM code valid for FY2027 (October 1, 2026 – September 30, 2027).
Can I50.41 be used as a principal diagnosis?
- Yes. The Medicare Code Editor doesn't restrict I50.41 as a principal diagnosis.
Is I50.41 a CC or MCC?
- I50.41 is an MCC (major complication or comorbidity) under MS-DRG v44.0, unless excluded by the principal diagnosis.
What DRG does I50.41 group to?
- I50.41 is used in the MS-DRG v44.0 logic for MS-DRG 291 (Heart Failure and Shock with MCC), MS-DRG 292 (Heart Failure and Shock with CC), MS-DRG 293 (Heart Failure and Shock without CC/MCC), MS-DRG 791 (Prematurity with Major Problems) and MS-DRG 793 (Full Term Neonate with Major Problems). Which one applies depends on whether it is the principal diagnosis and on the rest of the claim.
What is the ICD-9 code for I50.41?
- The CMS General Equivalence Mappings map I50.41 to ICD-9-CM 428.0, 428.41 and 428.41.