Home » ICD 10 » Superb Coding tips for Hypertensive Heart Kidney Disease in ICD 10

Superb Coding tips for Hypertensive Heart Kidney Disease in ICD 10

If you read the title, this will be the most common and confused coding scenario for medical coders. If you are fresher, you will surely have lot of questions how 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

Superb Coding tips for Hypertensive Heart Kidney Disease in ICD 10

Read also: Coding tips for initial, subsequent and Sequela encounter for Injuries

Coding Hypertensive or due to Heart disease

In 2017, there has been few changes in coding 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 in 2017, 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 coding guidelines in 2017, 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. 

The Diabetes Loophole Please Click Here!

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.

ICD 10 codes for Hypertension, Heart and Kidney Disease

I10 – Hypertension

I11 – Hypertensive Heart Disease

I12 – Hypertensive Chronic kidney Disease

I13 – Hypertensive Heart and Chronic kidney disease

I14 – Secondary Hypertension

Read also: How to Prepare and Clear CPC Exam

Coding for Hypertension kidney Heart Disease

 Now, after going through this article you should be easily code Hypertension kidney heart disease. Here, also we will follow the ICD coding guidelines of 2017. 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

Hope, you would have got some useful tips for coding hypertension, heart disease and renal disease. Do share it if you find it helpful.

Subscribe to Blog via Email

Enter your email address to subscribe to this blog and receive notifications of new posts by email.

Join 96 other subscribers

Understanding Medical Coding: A Comprehensive Guide CPT copyright 2014 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association
DMCA.com Protection Status CPT copyright 2014 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association