I50.42 Chronic combined systolic (congestive) and diastolic (congestive) heart failure

Billable ICD-10-CM code, FY2026. Acts as a Complication or Comorbidity (CC) as a secondary diagnosis.

Applies from I50 Heart failure

Excludes2 (not included here)

• cardiac arrest (I46.-)
• neonatal cardiac failure (P29.0)

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-)
• obstetric surgery and procedures (O75.4)
• rheumatic heart failure (I09.81)

Applies from I50.4 Combined systolic (congestive) and diastolic (congestive) heart failure

Applicable to

• Combined systolic and diastolic left ventricular heart failure
• Heart failure with reduced ejection fraction and diastolic dysfunction

Code also

• end stage heart failure, if applicable (I50.84)

Risk adjustment (HCC)

• CMS-HCC V28: HCC 226 — Heart Failure, Except End-Stage and Acute
• CMS-HCC V22: HCC 85 — Congestive Heart Failure
• RxHCC V08: HCC 186 — Heart Failure
• ESRD V24: HCC 85

MS-DRG index

Defines the logic of DRG(s) 291-293 in MDC 05.

Approximate ICD-9-CM (GEMs)

• 428.0 Congestive heart failure, unspecified (approximate)
• 428.42 Chronic combined systolic and diastolic heart failure (approximate)
• 428.42 Chronic combined systolic and diastolic heart failure (approximate)

Code annotations containing back-references to I50.42

Back-references to I50.4

• Type 1 Excludes: I50.2 Systolic (congestive) heart failure ("combined systolic (congestive) and diastolic (congestive) heart failure (I50.4-)")
• Type 1 Excludes: I50.3 Diastolic (congestive) heart failure ("combined systolic (congestive) and diastolic (congestive) heart failure (I50.4-)")

Back-references to I50

• Code Also: E83.820 Generalized arterial calcification of infancy with unspecified genetic causality ("heart failure (I50.-)")
• Code Also: E83.821 ENPP1 deficiency causing generalized arterial calcification of infancy ("heart failure (I50.-)")
• Code Also: E83.823 ABCC6 deficiency causing generalized arterial calcification of infancy ("heart failure (I50.-)")
• Use Additional: I09.81 Rheumatic heart failure ("code to identify type of heart failure (I50.-)")
• Use Additional: I11.0 Hypertensive heart disease with heart failure ("code to identify type of heart failure (I50.-)")
• Use Additional: I13.0 Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease ("code to identify type of heart failure (I50.-)")
• Use Additional: I13.2 Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease ("code to identify type of heart failure (I50.-)")
• Use Additional: I16.1 Hypertensive emergency ("acute pulmonary edema (left and/or right ventricular failure) (J81.0, I50.-)")
• Code First: I5A Non-ischemic myocardial injury (non-traumatic) ("heart failure (I50.-)")
• Use Additional: I97.13 Postprocedural heart failure ("code to identify the heart failure (I50.-)")
• Type 2 Excludes: J91 Pleural effusion in conditions classified elsewhere ("pleural effusion in heart failure (I50.-)")

Diagnosis Index entries for I50.42

• Failure, failed › heart (acute) (senile) (sudden) › diastolic (congestive) (left ventricular) › combined with systolic (congestive) › chronic (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) › chronic (congestive)

Nearby codes

• I50.32 Chronic diastolic (congestive) heart failure
• I50.33 Acute on chronic diastolic (congestive) heart failure
• I50.4 Combined systolic (congestive) and diastolic (congestive) heart failure
• I50.40 Unspecified combined systolic (congestive) and diastolic (congestive) heart failure
• I50.41 Acute combined systolic (congestive) and diastolic (congestive) heart failure
• I50.42 Chronic combined systolic (congestive) and diastolic (congestive) heart failure (this code)
• I50.43 Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure
• I50.8 Other heart failure
• I50.81 Right heart failure
• I50.810 Right heart failure, unspecified
• I50.811 Acute right heart failure