ICD-10 Coding for Hypertensive Heart Disease with Heart Failure(I11.0)
Complete ICD-10-CM coding and documentation guide for Hypertensive Heart Disease with Heart Failure. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hypertensive Heart Disease with Heart Failure
Key Information: ICD-10 code for hypertensive heart disease with heart failure
Essential facts and insights about Hypertensive Heart Disease with Heart Failure
Primary ICD-10-CM Code for hypertensive heart disease with heart failure
Decision Criteria
clinical Criteria
- Presence of hypertension and heart failure
coding Criteria
- Proper sequencing of I11.0 and I50 codes
Applicable To
- Hypertensive heart disease with heart failure
Excludes
- Hypertensive heart disease without heart failure (I11.9)
Clinical Validation Requirements
- Documented diagnosis of hypertension
- Evidence of heart failure (e.g., echocardiogram, BNP levels)
Code-Specific Risks
- Incorrect sequencing with heart failure codes
- Omission of specific heart failure type
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Hypertensive heart disease without heart failure
I11.9Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Hypertensive Heart Disease with Heart Failure to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I11.0.
Impact
Clinical: Inaccurate assessment of heart failure severity., Regulatory: Non-compliance with coding guidelines., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Ensure EF is documented in all heart failure cases.
Impact
Reimbursement: May lead to lower reimbursement due to unspecified coding., Compliance: Increases risk of audit due to lack of specificity., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Query provider for specific heart failure type and use appropriate I50 code.
Impact
High audit risk for using unspecified heart failure codes.
Mitigation Strategy
Educate providers on documenting specific heart failure types.
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 Heart Disease with Heart Failure, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hypertensive Heart Disease with Heart Failure
Use these documentation templates to ensure complete and accurate documentation for Hypertensive Heart Disease with Heart Failure. These templates include all required elements for proper coding and billing.
Hypertensive heart disease with acute systolic heart failure
Specialty: CardiologyRequired Elements
- Hypertension diagnosis
- Heart failure type and EF
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Hypertensive Heart Disease with Heart Failure? Ask your questions below.