ICD-10 code guides
Reviewed July 1, 2026

ICD-10 codes for heart failure

Heart-failure coding is driven by type and acuity: systolic, diastolic, combined systolic and diastolic, acute, chronic, or acute on chronic.

I50.9 billable

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1

Paste or dictate a de-identified clinical note — a few sentences is enough.

2

Press Get codes. The coding system is fixed on this page.

3

Review each suggested code and its evidence, then copy the codes you agree with.

Clinical note

ICD-10-CM

Extracted codes

Evidence stays attached for review.

Paste a clinical note or load an example, then press Get codes. Suggestions appear here with the supporting evidence.

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Heart failure ICD-10 codes

Start with the primary code, then move to a more specific related code when the documentation supports it.

CodeDescriptionSystem

I50.9

Heart failure, unspecified

ICD-10-CM

I50.22

Chronic systolic heart failure

ICD-10-CM

I50.23

Acute on chronic systolic heart failure

ICD-10-CM

I50.32

Chronic diastolic heart failure

ICD-10-CM

I50.33

Acute on chronic diastolic heart failure

ICD-10-CM

I50.42

Chronic combined systolic and diastolic heart failure

ICD-10-CM

How to choose the right code

Document ejection-fraction phenotype and acuity. HFrEF generally maps to systolic heart failure, HFpEF to diastolic heart failure, and documented acute decompensation changes chronic codes to acute or acute-on-chronic variants.

Documentation example

Known HFrEF with EF 32%. Three days of worsening dyspnea, orthopnea, and 3 kg weight gain. Bibasal crackles and ankle edema. Assessment: acute on chronic systolic heart failure; increased loop diuretic and arranged cardiology follow-up.

Suggested:

I50.23

Not direct transcript guessing

FactsContext extracts clinical facts first: diagnoses, symptoms, negatives, findings, test results, medications, and plan decisions.

Raw facts stay usable

The clinician can read and reuse the extracted medical context directly, independent of the generated note.

Built for review

AI suggestions are not a substitute for clinician judgment, payer rules, local coding policy, or the official code set.

FAQ

Why avoid I50.9?

I50.9 is valid when heart failure is unspecified, but type and acuity are often documented and support more specific I50.- codes.

How do I code acute on chronic heart failure?

Use the acute-on-chronic variant for the documented phenotype, such as I50.23 for acute on chronic systolic heart failure.

Can AI capture EF and acuity?

Notat extracts EF, HF phenotype, decompensation signs, and assessment as clinical facts, then suggests the supported heart-failure code with evidence.

Related ICD-10 guides

Keep moving through the condition hub, or open the general medical coding guide for more coding systems and extractors.

Medical coding hub