ICD-10 Coding for Uncontrollable Hypertension(I10, I11.0, I12.9, I1A.0)
Complete ICD-10-CM coding and documentation guide for Uncontrollable Hypertension. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Uncontrollable Hypertension
I10-I15Primary Range
Hypertensive diseases
This range includes all primary codes for hypertension, including essential, secondary, and hypertensive heart and renal disease.
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 specified organ involvement. |
|
| I11.0 | Hypertensive heart disease with heart failure | Use when hypertension is accompanied by heart failure. |
|
| I12.9 | Hypertensive chronic kidney disease with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease | Use when hypertension is associated with CKD stages 1-4. |
|
| I1A.0 | Resistant hypertension | Use when hypertension is not controlled despite 3+ medications. |
|
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 uncontrollable hypertension
Essential facts and insights about Uncontrollable Hypertension
Primary ICD-10-CM Codes for uncontrollable hypertension
Decision Criteria
clinical Criteria
- Diagnosis of hypertension without organ damage
Applicable To
- High blood pressure
Clinical Validation Requirements
- Diagnosis of hypertension without specified organ damage
Code-Specific Risks
- Misclassification if organ damage is present
Coding Notes
- Ensure no organ damage is documented when using I10.
I11.0 - Hypertensive heart disease with heart failure
Use when hypertension is accompanied by heart failure.
Applicable To
- Hypertensive heart disease with heart failure
Excludes
- Heart failure without hypertension (I50.-)
Clinical Validation Requirements
- Echocardiogram showing left ventricular hypertrophy
- Documented heart failure symptoms
Coding Notes
Document both hypertension and heart failure clearly.
I12.9 - Hypertensive chronic kidney disease with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
Use when hypertension is associated with CKD stages 1-4.
Applicable To
- Hypertensive CKD without renal failure
Excludes
- Hypertensive heart and renal disease (I13.-)
Clinical Validation Requirements
- eGFR <60 mL/min/1.73 m²
- Urine albumin/creatinine ratio ≥30 mg/g
Coding Notes
Link hypertension and CKD in documentation.
I1A.0 - Resistant hypertension
Use when hypertension is not controlled despite 3+ medications.
Applicable To
- Hypertension not controlled with 3+ medications
Excludes
- Hypertensive crisis (I16.-)
Clinical Validation Requirements
- BP ≥140/90 mmHg on 3+ medications including a diuretic
- Documentation of medication adherence
Coding Notes
Document all medications and adherence verification.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Uncontrollable Hypertension to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I10.
Impact
Clinical: May lead to under-treatment of hypertension., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Ensure formal diagnosis of hypertension is documented.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Use R03.0 for elevated BP without a formal hypertension diagnosis.
Impact
Reimbursement: May affect reimbursement for resistant hypertension management., Compliance: Non-compliance with documentation standards., Data Quality: Inaccurate representation of patient management.
Mitigation Strategy
Ensure documentation includes adherence verification methods.
Impact
Lack of adherence documentation may trigger audits.
Mitigation Strategy
Ensure adherence is documented through reliable methods.
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 Uncontrollable Hypertension, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Uncontrollable Hypertension
Use these documentation templates to ensure complete and accurate documentation for Uncontrollable Hypertension. These templates include all required elements for proper coding and billing.
Resistant Hypertension Management
Specialty: CardiologyRequired Elements
- Blood pressure readings
- Medication list
- Adherence verification
- Exclusion of secondary causes
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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