I50.82 ICD-10-CM Code: Biventricular heart failure
I50.82 maps to CMS-HCC V28 226 (RAF 0.360). Documentation must support MEAT. MEAT criteria · RAF calculator · free HCC coding tools
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FY 2026 Apr update / Diseases of the circulatory system (I00-I99) / Other forms of heart disease (I30-I5A)
I50.82
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceBiventricular heart failure
Both the right and left sides of the heart are not functioning properly at the same time, affecting the heart's overall ability to pump blood.
Buddy Insight
Biventricular heart failure indicates that both the left and right ventricles are failing simultaneously, representing advanced cardiac disease with poor prognosis.
CMS-HCC V28
MappedHCC 226
RAF 0.360
CMS-HCC V24
MappedHCC 85
RAF 0.331
ACA/HHS
MappedHCC 130
Varies by metal level
ESRD/PACE
MappedHCC 85
RAF 0.063
RXHCC
MappedHCC 186
RAF 0.110
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for I50.82 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for I50.82 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for I50.82 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for I50.82 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for I50.82 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for I50.82 in this effective period.
Code Also
Official- the type of left ventricular failure as systolic, diastolic, or combined, if known (I50.2-I50.43)
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is I50.82 an HCC code?
Yes. I50.82 (Biventricular heart failure) maps to Heart Failure, Except End Stage and Acute under the CMS-HCC V28 risk adjustment model (and Congestive Heart Failure under V24), with a community non-dual aged RAF of 0.360. It is billable for payment year 2026.
Coder answer: I50.82 is billable and maps to V28 HCC 226, Heart Failure, Except End Stage and Acute. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.
- Code
- I50.82
- Description
- Biventricular heart failure
- HCC (V28)
- HCC 226 — Heart Failure, Except End Stage and Acute
- RAF
- 0.360
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
Each model's RAF is its CMS base weight for that model's standard population, so 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 segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
Work I50.82 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for I50.82
For I50.82 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed I50.82 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
I50.82 is the ICD-10-CM diagnosis code for biventricular heart failure. Both the right and left sides of the heart are not functioning properly at the same time, affecting the heart's overall ability to pump blood. I50.82 sits in the ICD-10-CM chapter for diseases of the circulatory system (i00-i99), within the section covering other forms of heart disease (i30-i5a).
Under the CMS-HCC V28 risk adjustment model, I50.82 maps to Heart Failure, Except End Stage and Acute (HCC 226) with a community, non-dual, aged base RAF weight of 0.360. Under the older CMS-HCC V24 model, I50.82 maps to Congestive Heart Failure (HCC 85) with a community, non-dual, aged base RAF weight of 0.331. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
Biventricular heart failure. Provider documents HF involving both ventricles, EF reduced with evidence of right-sided congestion, or imaging supporting both LV and RV dysfunction. Because I50.82 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for I50.82 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Biventricular heart failure. Provider documents HF involving both ventricles, EF reduced with evidence of right-sided congestion, or imaging supporting both LV and RV dysfunction.
- •Do not use I50.82 when only one ventricle is involved, I50.2x (systolic, typically LV), I50.3x (diastolic), or I50.81x (right) apply instead. Also, biventricular HF typically requires pairing with a specific left-HF subtype per coding convention.
- •V28 HCC 226 at RAF 0.36. Biventricular HF is clinically advanced but shares the HCC weight; chart specificity supports audit trail.
Clinical Significance
Biventricular heart failure indicates that both the left and right ventricles are failing simultaneously, representing advanced cardiac disease with poor prognosis. These patients have significantly higher mortality and resource utilization compared to isolated left or right heart failure. Complete documentation of both ventricles' dysfunction is critical.
Documentation Requirements
- ✓Provider must document biventricular heart failure or bilateral heart failure
- ✓Echocardiographic evidence of both left and right ventricular dysfunction
- ✓Functional status and New York Heart Association class
- ✓Current comprehensive treatment plan
- ✓Signs and symptoms of both left-sided (dyspnea, pulmonary edema) and right-sided (peripheral edema, ascites) failure
- ✓Whether the patient is being evaluated for advanced therapies (transplant, ventricular assist device)
Code Also
Commonly Confused Codes
- •I50.814: Right heart failure due to left heart failure: specifies causal relationship between left and right failure
- •I50.84: End stage heart failure: terminal stage, may coexist with biventricular failure
- •I50.9: Heart failure, unspecified: nonspecific, does not capture biventricular nature
- •I50.22: Chronic systolic heart failure: only left-sided dysfunction
- •I50.812: Chronic right heart failure: only right-sided dysfunction