ICD-10 Code I50.4 – Combined systolic (congestive) and diastolic (congestive) heart failure (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code I50.4 – Combined systolic (congestive) and diastolic (congestive) heart failure
What it is
This code identifies heart failure with both reduced pumping function and impaired filling. Use it when documentation states combined systolic and diastolic congestive heart failure.
Clinical signs
Typical findings include dyspnea, fatigue, edema, and other signs of fluid overload or reduced cardiac output. Clinical features vary; refer to documentation.
When to use this code
Use I50.4 when the provider specifically documents combined systolic and diastolic heart failure, or clearly describes both types in the same encounter. You may also use it when the record states congestive heart failure with both systolic and diastolic dysfunction. Check documentation if the type is not explicit.
Do not use for
Do not use this code for isolated systolic, isolated diastolic, or unspecified heart failure. If the note only says “CHF” without further detail, check documentation before assigning a more specific code.
Coding tip
Code the most specific heart failure type documented, and query the provider when systolic and diastolic involvement is unclear.