MDC 05 Diseases & Disorders of the Circulatory System Heart Failure and Shock
I0981 Rheumatic heart failure I110 Hypertensive heart disease with heart failure I130 Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease I132 Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease I501 Left ventricular failure, unspecified I5020 Unspecified systolic (congestive) heart failure I5021 Acute systolic (congestive) heart failure I5022 Chronic systolic (congestive) heart failure I5023 Acute on chronic systolic (congestive) heart failure I5030 Unspecified diastolic (congestive) heart failure I5031 Acute diastolic (congestive) heart failure I5032 Chronic diastolic (congestive) heart failure I5033 Acute on chronic diastolic (congestive) heart failure I5040 Unspecified combined systolic (congestive) and diastolic (congestive) heart failure I5041 Acute combined systolic (congestive) and diastolic (congestive) heart failure I5042 Chronic combined systolic (congestive) and diastolic (congestive) heart failure I5043 Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure I50810 Right heart failure, unspecified I50811 Acute right heart failure I50812 Chronic right heart failure I50813 Acute on chronic right heart failure I50814 Right heart failure due to left heart failure I5082 Biventricular heart failure I5083 High output heart failure I5084 End stage heart failure I5089 Other heart failure I509 Heart failure, unspecified R570 Cardiogenic shock R579 Shock, unspecified
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Basic information on Hypertension ICD 10 code
If you read the title, this will be the most common and confused coding scenario for medical coders. If you are fresher you will know Hypertension ICD 10 code but you will surely have lot of questions on when to code hypertension with heart disease, hypertension with kidney disease and when to code all of them together. Since these diseases are very closely linked with each other, we will be having problem for coding them. In Medical coding certification exam like CPC, there are questions from these topics and it is very important to know how to code such conditions. Now, let us learn how to deal with these scenarios and clear your confusions
Read also: Coding tips for initial, subsequent and Sequela encounter for Injuries
Coding Hypertensive or due to Heart disease
From 2017, the ICD 10 coding guidlines has allowed to code Hypertension and Heart disease together. Earlier we have to look for any causal relationship between Hypertension and heart disease, but with updated guidelines in 2017, you don’t have to look for any causal relationship. Unless and until the physician documents that hypertension and heart diseases are unrelated, you can assume a causal relationship between them. Hence, going forward don’t look for “hypertensive” or “due to” phrases to find a relationship between them. Just assume and code the combination code once you find both hypertension and heart disease documented in the report. If provider documents clearly that they are not related to each other, then only we have to code them separately. So as per ICD 10 coding guidelines, you can assume a relationship between a Hypertension (I10) and Heart disease. In short just check below when we will use combination code
Hypertension and/or Heart disease – Use a combination code (I11) followed by the type of Heart disease (I50 category)
Hypertensive or due to Heart disease – Use a combination code (I11) followed by the
type of Heart disease (I50 category)
When clearly documented as unrelated – Code Separately hypertension (I10) and Heart Disease
Hope this will clear your doubt about coding hypertension and heart disease.
ICD 10 codes for Hypertensive Heart Disease
We have separate ICD 10 code for Essential or primary Hypetension, I10 which includes high blood pressure, arterial, benign, malignant, systemic. For coding hypertensive heart disease we have to use below list of ICD o codes for I11 series.
I11 Hypertensive heart disease
I11.0 Hypertensive heart disease with heart failure
Hypertensive heart failure
Use additional code to identify type of heart failure (I50.-)
We have to use type of heart failure along with I11.0 ICD 10 code as a secondary code. Below are the list of heart failure codes should be used along with I11.o code.
- I50.1, Left ventricular failure,
- I50.2, Systolic (congestive) heart failure,
- I50.3, Diastolic (congestive) heart failure,
- I50.4, Combined systolic and diastolic heart failure,
- I50.9, Heart failure, unspecified.The three codes for systolic, diastolic, and combined
failure also require a fifth digit specifying the acuity of the diagnosis:
- 0, Unspecified,
- 1, Acute,
- 2, Chronic,
- 3, Acute on chronic.
I11.9 Hypertensive heart disease without heart failure
Hypertensive heart disease NOS
Read also: When to use Z codes in IC10
Coding Hypertension and/with Chronic Kidney Disease (CKD)
As per the updated coding guidelines , if there is mention of hypertension and Chronic kidney disease, you can assume a causal relationship between them. Like hypertension and heart disease you can assume a relationship between CKD and hypertension as well. We can go ahead and use combination code for hypertension and Kidney disease irrespective of And or With. The simple rule here we have to use a combination code if there is documentation of hypertension and Chronic Renal Disease anywhere in the medical report.
Do remember if the provider documents that both hypertension and Chronic kidney disease are unrelated, we have to code them separately.
Hypertension and/with Chronic kidney disease – use a Combination code (I12) for hypertension and Chronic kidney disease followed by the type or stage of Chronic kidney disease.
ICD 10 codes for Hypertension Chronic kidney disease
ICD 10 code category, I12 represent the Hypertensive chronic kidney disease.
I12.0 Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease
We have to use additional code to identify the stage of chronic kidney disease (N18.5,N18.6)
I12.9 Hypertensive chronic kidney disease with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease.
This code should be used for hypertensive chronic kidney disease, hypertensive renal disease. We should also use a secondary ICD 10 code to specify the stage of CKD (N18.1-N18.4, N18.9)
Below are the ICD 10 codes for different stages of Chronic kidney disease.
- N18.1, Chronic kidney disease, stage 1,
- N18.2, Chronic kidney disease, stage 2 (mild),
- N18.3, Chronic kidney disease, stage 3 (moderate),
- N18.4, Chronic kidney disease, stage 4 (severe),
- N18.5, Chronic kidney disease, stage 5,
- N18.6, End-stage renal disease,
- N18.9, Chronic kidney disease, unspecified.
I10 – Hypertension
I11 – Hypertensive Heart Disease
I12 – Hypertensive Chronic kidney Disease
I13 – Hypertensive Heart and Chronic kidney disease
I15 – Secondary Hypertension
Read also: How to Prepare and Clear CPC Exam
Coding for Hypertension kidney Heart DiseaseNow, after going through this article you should be easily code Hypertension kidney heart disease. Here, we have to completely follow the ICD 10 coding guidelines. If the documentation support all the three condition i.e. hypertensive heart kidney disease, we will go ahead and code a combination code from I13 category for hypertensive heart kidney disease. If the provider documents their is no relationship between hypertension and heart disease or renal disease we can code it separately for Hypertension I10 and Heart disease/renal disease category. The simple rule here is just follow the ICD coding guidelines and it will easy for you to select the appropriate diagnosis codes.
For patients with both acute renal failure and chronic kidney disease, an additional code for acute renal failure is required.
ICD 10 codes for Hypertensive heart and chronic kidney disease w/wo heart failure
I13 Hypertensive heart and chronic kidney disease
I13.0 Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
code additional code for the type of heart failure (I50.-) and stage of CKD
I13.1 Hypertensive heart and chronic kidney disease without heart failure
I13.10 Hypertensive heart and chronic kidney disease without heart failure, with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
use additional code for the stage of CKD.
I13.2 Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease
code additional code for the type of heart failure (I50.-) and stage of CKD
Additional ICD 1o codes for Hypertension
I15 Secondary hypertension
I15.0 Renovascular hypertension
I15.1 Hypertension secondary to other renal disorders
I15.2 Hypertension secondary to endocrine disorders
I15.8 Other secondary hypertension
I15.9 Secondary hypertension, unspecified
ICD-10 is required for use by physicians and healthcare providers under the Health Insurance Portability & Accountability Act (HIPAA).
Hope, you would have got some useful tips for Hypertension ICD 10 coding and combination code for hypertension, heart disease and renal disease. Do share it if you find it helpful.