I50.43 — Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure
Is I50.43 billable?
Yes — I50.43 is billable for FY2027. I50.43 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. I50.43 may be submitted for encounters from October 1, 2026 through September 30, 2027.
I50.43 at a glance
| Code | I50.43 |
|---|---|
| Description | Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Which MS-DRGs does I50.43 group to?
I50.43 sits in MDC 05 and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 291Heart Failure and Shock with MCCmedical
- 292Heart Failure and Shock with CCmedical
- 293Heart Failure and Shock without CC/MCCmedical
As a secondary diagnosis, I50.43 is a major complication or comorbidity (MCC), which can move a stay into a higher-paying DRG.
How is I50.43 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to I50.43. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Failure, failed › heart › with › decompensation › combined systolic and diastolic
- Failure, failed › heart › diastolic › combined with systolic › acute › and
- Failure, failed › heart › diastolic › combined with systolic › chronic › and
- 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 › combined with diastolic › acute › and
- 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 › combined with diastolic › chronic › and
- Failure, failed › heart › with › decompensation › with › reduced ejection fraction › with diastolic dysfunction
Code first — inherited from I50
The underlying condition below must be sequenced before I50.43. I50.43 describes a manifestation and cannot be the principal or first-listed diagnosis.
- 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)
Excludes2 — not included here — inherited from Chapter 9
The conditions below are not part of I50.43, but a patient may have both at the same time. When documentation supports it, I50.43 and the excluded code may both be reported.
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
- systemic connective tissue disorders (M30-M36)
- transient cerebral ischemic attacks and related syndromes (G45.-)
Excludes2 — not included here — inherited from I50
The conditions below are not part of I50.43, but a patient may have both at the same time. When documentation supports it, I50.43 and the excluded code may both be reported.
Code also — inherited from I50.4
Two codes may be needed to describe the condition fully. Whether I50.43 is sequenced first depends on the reason for the encounter.
- end stage heart failure, if applicable (I50.84)
How long has I50.43 existed?
I50.43 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.