I50.84: End stage heart failure

I50.84, end stage heart failure, is listed as a covered diagnosis in 8 Medicare billing and coding articles that apply to 42 HCPCS Level II codes, including G0422 (Intensive cardiac rehabilitation; with or without…), G0423 (Intensive cardiac rehabilitation; with or without…), C7539 (Insertion of new or replacement of permanent pacemaker…). The articles come from 3 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.

HCPCS Level II codes with I50.84 as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
G0422Intensive cardiac rehabilitation; with or without continuous ecg monitoring with exercise, per sessionCarrier judgment—1
G0423Intensive cardiac rehabilitation; with or without continuous ecg monitoring; without exercise, per sessionCarrier judgment—1
C7539Insertion of new or replacement of permanent pacemaker with atrial and ventricular transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pacemaker pulse generator (eg, for upgrade to dual chamber system)Special coverage instructions apply—1
C7538Insertion of new or replacement of permanent pacemaker with ventricular transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pacemaker pulse generator (e.g., for upgrade to dual chamber system)Special coverage instructions apply—1
C7540Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator, dual lead system, with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pacemaker pulse generator (eg, for upgrade to dual chamber system)Carrier judgment—1
C7537Insertion of new or replacement of permanent pacemaker with atrial transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pacemaker pulse generator (e.g., for upgrade to dual chamber system)Special coverage instructions apply—1
G0448Insertion or replacement of a permanent pacing cardioverter-defibrillator system with transvenous lead(s), single or dual chamber with insertion of pacing electrode, cardiac venous system, for left ventricular pacingCarrier judgment—1
A9500Technetium tc-99m sestamibi, diagnostic, per study doseCarrier judgment—2
A9502Technetium tc-99m tetrofosmin, diagnostic, per study doseCarrier judgment—2
A9505Thallium tl-201 thallous chloride, diagnostic, per millicurieCarrier judgment—2
A9501Technetium tc-99m teboroxime, diagnostic, per study doseCarrier judgment—2
J0461Injection, atropine sulfate, 0.01 mgSpecial coverage instructions apply—3
J0153Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds)Special coverage instructions apply—3
J1250Injection, dobutamine hydrochloride, per 250 mgSpecial coverage instructions apply—3
J0280Injection, aminophyllin, up to 250 mgSpecial coverage instructions apply—3
J1245Injection, dipyridamole, per 10 mgSpecial coverage instructions apply—3
A9512Technetium tc-99m pertechnetate, diagnostic, per millicurieCarrier judgment—1
A9560Technetium tc-99m labeled red blood cells, diagnostic, per study dose, up to 30 millicuriesCarrier judgment—1
A9538Technetium tc-99m pyrophosphate, diagnostic, per study dose, up to 25 millicuriesCarrier judgment—1
A9520Technetium tc-99m tilmanocept, diagnostic, up to 0.5 millicuriesCarrier judgment—1
C9176Tc-99m from domestically produced non-heu mo-99, [minimum 50 percent], full cost recovery add-on, per study doseSpecial coverage instructions apply—1
A9700Supply of injectable contrast material for use in echocardiography, per studySpecial coverage instructions apply—2
A9555Rubidium rb-82, diagnostic, per study dose, up to 60 millicuriesCarrier judgment—1
A9526Nitrogen n-13 ammonia, diagnostic, per study dose, up to 40 millicuriesCarrier judgment—1
A4641Radiopharmaceutical, diagnostic, not otherwise classifiedCarrier judgment—1

17 more codes are listed. See every code with payment by region in Caduvo.

Medicare policy articles listing I50.84

A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.

Other I50 diagnoses (Heart failure)

Frequently asked questions

Does Medicare cover I50.84 (End stage heart failure)?

Medicare covers items and services, not diagnoses. 8 Medicare billing and coding articles list I50.84 as a covered diagnosis for 42 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.

Which HCPCS codes can be billed with ICD-10 I50.84?

The Level II codes from the policies most specific to this diagnosis are G0422 (Intensive cardiac rehabilitation; with or without…, 1 article); G0423 (Intensive cardiac rehabilitation; with or without…, 1 article); C7539 (Insertion of new or replacement of permanent pacemaker…, 1 article); C7538 (Insertion of new or replacement of permanent pacemaker…, 1 article); C7540 (Removal of permanent pacemaker pulse generator with…, 1 article). Code choice depends on the item supplied; check each code's descriptor.

Which Medicare policy articles list I50.84?

A53775 (Billing and Coding: Frequency and Duration for Cardiac Rehabilitation and Intensive Cardiac Rehabilitation); A56391 (Billing and Coding: Implantable Automatic Defibrillators); A56743 (Billing and Coding: Cardiovascular Nuclear Medicine), and 5 more articles.

What is ICD-10-CM code I50.84?

I50.84 is the ICD-10-CM code for end stage heart failure, in category I50 (Heart failure), chapter 9: Diseases of the circulatory system.

Next steps

Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.

Chapter 9: Diseases of the circulatory system · All diagnoses · HCPCS lookup