ICD-10 Coding for Hypertensive Disorder(I10, I11.0, I12.9)
Complete ICD-10-CM coding and documentation guide for Hypertensive Disorder. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hypertensive Disorder
I10-I16Primary Range
Hypertensive diseases
This range includes all hypertensive disorders, from essential hypertension to hypertensive heart and kidney diseases.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I10 | Essential (primary) hypertension | Use when hypertension is diagnosed without any associated organ damage. |
|
| I11.0 | Hypertensive heart disease with heart failure | Use when heart failure is present and attributed to hypertension. |
|
| I12.9 | Hypertensive chronic kidney disease with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease | Use when CKD stages 1-4 are present with hypertension. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for hypertensive disorder
Essential facts and insights about Hypertensive Disorder
Primary ICD-10-CM Codes for hypertensive disorder
Decision Criteria
clinical Criteria
- BP readings consistently above 140/90 mmHg without organ damage.
Applicable To
- High blood pressure
- Hypertension
Clinical Validation Requirements
- Two separate BP readings >140/90 mmHg
Code-Specific Risks
- Misclassification if organ damage is present but not documented.
Coding Notes
- Ensure no organ damage is present before using I10.
I11.0 - Hypertensive heart disease with heart failure
Use when heart failure is present and attributed to hypertension.
Applicable To
- Hypertensive heart disease with heart failure
Excludes
- Heart failure not due to hypertension (I50.-)
Clinical Validation Requirements
- Echocardiogram showing left ventricular hypertrophy
- BNP >400 pg/mL
Coding Notes
Sequence I11.0 before heart failure codes.
I12.9 - Hypertensive chronic kidney disease with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
Use when CKD stages 1-4 are present with hypertension.
Applicable To
- Hypertensive CKD without ESRD
Excludes
- Hypertensive heart and CKD (I13.-)
Clinical Validation Requirements
- eGFR <60 mL/min/1.73 m²
- Proteinuria
Coding Notes
Ensure CKD stage is documented.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Hypertensive Disorder to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I10.
Impact
Clinical: Misrepresentation of patient's condition., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Review patient records for any organ damage before coding.
Impact
Reimbursement: Incorrect sequencing can lead to lower DRG reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Always code I11.0 before I50.- codes.
Impact
Risk of incorrect code sequencing and documentation.
Mitigation Strategy
Regular training on ICD-10 guidelines and documentation standards.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Hypertensive Disorder, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hypertensive Disorder
Use these documentation templates to ensure complete and accurate documentation for Hypertensive Disorder. These templates include all required elements for proper coding and billing.
Hypertensive heart disease with heart failure
Specialty: CardiologyRequired Elements
- Blood pressure readings
- Heart failure type
- Echocardiogram results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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