Chronic combined systolic (congestive) and diastolic (congestive) heart failure
CMS-HCC V28
HCC 226
RAF 0.360
CMS-HCC V24
HCC 85
RAF 0.331
RxHCC
RxHCC 186
RAF 0.110
Index trail
Chronic combined systolic (congestive) and diastolic (congestive) heart failure
See Tabular List: I50.42
I50, Heart failure
I50.4, Combined systolic (congestive) and diastolic (congestive) heart failure
I50.42, Chronic combined systolic (congestive) and diastolic (congestive) heart failure
Selected code, source checked for the selected effective period
Not listed for this effective period.
Chronic combined systolic (congestive) and diastolic (congestive) heart failure
Open the shareable code page for I50.42→No Excludes 1 note is listed in this source payload.
No Excludes 2 note is listed in this source payload.
Not listed for this effective period.
Not listed for this effective period.
Not listed for this code in the selected Tabular payload.
Not listed for this code in the selected Tabular payload.
No laterality instruction is listed for this code in the selected Tabular payload.
Index trail
Chronic combined systolic (congestive) and diastolic (congestive) heart failure
See Tabular List: I50.42
I50, Heart failure
I50.4, Combined systolic (congestive) and diastolic (congestive) heart failure
I50.42, Chronic combined systolic (congestive) and diastolic (congestive) heart failure
Selected code, source checked for the selected effective period
Not listed for this effective period.
Chronic combined systolic (congestive) and diastolic (congestive) heart failure
Open the shareable code page for I50.42→No Excludes 1 note is listed in this source payload.
No Excludes 2 note is listed in this source payload.
Not listed for this effective period.
Not listed for this effective period.
Not listed for this code in the selected Tabular payload.
Not listed for this code in the selected Tabular payload.
No laterality instruction is listed for this code in the selected Tabular payload.
HCC Mapping
RAF Value
Model Period
Source
Audit Caution
HCC mapping, RAF, MEAT, source trail, and audit caution stay in view.
V28
HCC 226
Heart Failure, Except End Stage and Acute
RAF: 0.360
V24
HCC 85
Congestive Heart Failure
RAF: 0.331
RxHCC
RxHCC 186
Heart Failure
RAF: 0.110
ESRD/PACE
HCC 85
Congestive Heart Failure
RAF: 0.063
HHS-HCC
HCC 130
HHS-HCC 130; HHS-HCC 2026 benefit year
RAF: Varies by metal level
MEAT checklist
Reviewed by the HCC Buddy Coding TeamMonitor, Evaluate, Assess, or Treat must be supported in the provider note.
HCC Buddy guidance, not official ICD-10-CM text.
Audit caution
Reviewed by the HCC Buddy Coding TeamClose codes need documentation support before selection. Do not assume relationships.
HCC Buddy guidance, not official ICD-10-CM text.
Reviewer sign-off
Reviewed by the HCC Buddy Coding TeamMEAT, documentation support, audit cautions, and close-code guidance are reviewed and approved for this effective period.
HCC Buddy enrichment is separate from official source text.
Chronic combined systolic (congestive) and diastolic (congestive) heart failure
CMS-HCC V28
HCC 226
RAF 0.360
CMS-HCC V24
HCC 85
RAF 0.331
RxHCC
RxHCC 186
RAF 0.110
Code
I50.42
V28 HCC
HCC 226
RAF
0.360
Add close codes to compare documentation differences.