I50.814 ICD-10-CM Code: Right heart failure due to left heart failure

Code

I50.814

Description

Right heart failure due to left heart failure

HCC (V28)

HCC 226 — Heart Failure, Except End Stage and Acute

RAF reference coefficient

0.360

Billable

Yes

Payment year

2026

HCC Category Mapping

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work I50.814 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for I50.814

What This Code Means

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for I50.814 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

• •Right heart failure due to left heart failure. Provider must document left HF as the driver of the right-sided component, a combined presentation with LV dysfunction causing secondary RV dysfunction.
• •Do not use I50.814 without also supporting the left HF documentation, the code presumes left HF as etiology. Pair with the specific I50.2x or I50.3x code for the left component per ICD-10-CM instruction.
• •This code captures the biventricular cascade and should be paired with the left-HF code when documentation supports each.

Clinical Significance

Right heart failure due to left heart failure identifies the etiology of right ventricular dysfunction as secondary to left-sided heart disease. This is the most common cause of right heart failure and indicates biventricular disease progression. Proper coding requires both this code and the underlying left heart failure code to fully represent disease complexity.

Documentation Requirements

• ✓Provider must document right heart failure caused by or secondary to left heart failure
• ✓Left heart failure type and acuity must also be documented and coded separately
• ✓Evidence of biventricular dysfunction on echocardiogram
• ✓Signs of right heart failure: peripheral edema, jugular venous distension, hepatomegaly
• ✓Treatment plan addressing both left and right heart failure
• ✓Use additional code for left heart failure type (I50.2-, I50.3-, I50.4-)

Commonly Confused Codes

• •I50.82: Biventricular heart failure: may be used when both ventricles are failing but without specifying the causal relationship
• •I50.810: Right heart failure, unspecified: does not specify the etiology
• •I50.812: Chronic right heart failure: does not specify left heart disease as the cause
• •I27.81: Cor pulmonale (chronic): right heart failure due to lung disease, not left heart disease
• •I50.22: Chronic systolic heart failure: the underlying left heart condition, coded separately

Child Codes