ICD-10 Coding for Hypertensive Nephrosclerosis(I12.9, I12.0)
Complete ICD-10-CM coding and documentation guide for Hypertensive Nephrosclerosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hypertensive Nephrosclerosis
I12-I13Primary Range
Hypertensive heart and chronic kidney disease
This range includes codes for hypertensive heart and chronic kidney disease, which are directly related to hypertensive nephrosclerosis.
Chronic kidney disease (CKD)
This range includes codes for different stages of CKD, which are necessary for specifying the stage of kidney disease in hypertensive nephrosclerosis.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I12.9 | Hypertensive chronic kidney disease with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease | Use when documenting hypertensive nephrosclerosis with CKD stages 1-4. |
|
| I12.0 | Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease | Use when documenting hypertensive nephrosclerosis with CKD stage 5 or ESRD. |
|
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 nephrosclerosis
Essential facts and insights about Hypertensive Nephrosclerosis
Primary ICD-10-CM Codes for hypertensive nephrosclerosis
Decision Criteria
clinical Criteria
- Documented hypertension with CKD stage 1-4
Applicable To
- Hypertensive nephrosclerosis with CKD stages 1-4
Excludes
- Hypertensive heart AND chronic kidney disease (I13.-)
Clinical Validation Requirements
- eGFR <60 for ≥3 months
- Proteinuria ≥300 mg/day
- Renal biopsy confirming nephrosclerosis
Code-Specific Risks
- Incorrectly coding without specifying CKD stage
Coding Notes
- Ensure CKD stage is documented to avoid unspecified coding.
I12.0 - Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease
Use when documenting hypertensive nephrosclerosis with CKD stage 5 or ESRD.
Applicable To
- Hypertensive nephrosclerosis with CKD stage 5 or ESRD
Excludes
- Hypertensive heart AND chronic kidney disease (I13.-)
Clinical Validation Requirements
- eGFR <15 or dialysis dependency
- Renal biopsy confirming nephrosclerosis
Coding Notes
Ensure ESRD or dialysis status is documented.
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.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Hypertensive Nephrosclerosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I12.9.
Impact
Clinical: Inaccurate clinical picture, Regulatory: Non-compliance with coding standards, Financial: Potential for denied claims
Mitigation Strategy
Review latest lab results, Ensure CKD stage is documented
Impact
Reimbursement: Incorrect reimbursement due to lack of linkage., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate data representation of patient condition.
Mitigation Strategy
Use I12.x codes to link hypertension and CKD.
Impact
Failure to link hypertension and CKD can lead to audit findings.
Mitigation Strategy
Ensure documentation explicitly links conditions.
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 Nephrosclerosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hypertensive Nephrosclerosis
Use these documentation templates to ensure complete and accurate documentation for Hypertensive Nephrosclerosis. These templates include all required elements for proper coding and billing.
Hypertensive Nephrosclerosis with CKD Stage 3
Specialty: NephrologyRequired Elements
- Blood pressure history
- eGFR and proteinuria levels
- Renal biopsy findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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