Hypertension ICD-10-CM Code Reporting Table
November 25th, 2019 - Wyn Staheli, Director of Research
When high blood pressure occurs without a known cause or in relation to another medical condition (e.g., chronic kidney disease) it is known as essential or primary hypertension. Sometimes there are no symptoms. Over time, the long-term force of blood against artery and vessel walls can cause a variety of health problems. In ICD-10-CM, hypertension code options do not distinguish between malignant and benign or between controlled and uncontrolled as they did in ICD-9-CM. What is important for code selection is knowing if the hypertension is caused by or related to another condition. The following helpful table shows some of these options.
Note: See Section 1;C.9.a of the ICD-10-CM Official Guidelines for Coding & Reporting for further guidance.
||I10 if there are no associated causal relationships (e.g., heart disease)
|w/ cardiorenal disease
||I13.-: this combination code includes hypertension, heart disease, and CKD.
- If there is heart failure, use additional code from category I50.-
- Do not use with codes from categories I11.- and I12.-.
Note: If there is acute renal failure, add that code.
|w/ chronic kidney disease
||Patient has CKD classifiable with N18.-
Note: If there is acute renal failure, add that code
- I12.-: this combination code includes hypertension and CKD
- N18.- is sequenced first, followed by I12.-
- if there is also kidney involvement, see cardiorenal.
|w/ eye involvement
||Report a code from subcategory H35.0- and a code from I10-I15. Sequence according to the reason for the encounter.
|w/ heart disease
||Patient has heart condition classified with I50.- or I51.4-I51.9
Note: If there is also kidney involvement, use cardiorenal codes instead.
- hypertension is related: use code from category I11.-
- hypertension is unrelated: sequence according to reason for the encounter
|w/ kidney involvement
||Hypertensive renal disease NOS or CKD stages 1-4 use code I12.9. Otherwise,see cardiorenal disease codes.
Note: If there is also heart involvement, use cardiorenal codes instead.
- pre-existing: see O10.- and O11.-
- pregnancy-induced: see O13.-, O14.-, O16.-
|w/ pulmonary involvement
- pulmonary hypertension: use code from I27.-
- secondary pulmonary hypertension (I27.1, I27.2-), code also any associated conditions or adverse effects of drugs or toxins
- sequence according to reason for the encounter, except for adverse effects of drugs (See Section I.C.19.e.)
||Code first applicable code from categories I60-I69, then report applicable hypertension code.
||Blood pressure is 180/120 or greater. Use code from I16.-
- Code also any identified hypertensive disease (I10-I15)
- Sequence according to reason for the encounter.
||Secondary: Hypertension is due to underlying condition not otherwise classified. Two codes are required: one to identify the underlying etiology and one from category I15- to identify the hypertension. Sequence according to reason for the encounter.
If you have questions or comments about this article please contact us. Comments that provide additional related information may be added here by our Editors.
Latest articles: (any category)COVID Vaccine Coding Changes as of November 1, 2023October 26th, 2023 - Wyn Staheli
COVID vaccine changes due to the end of the PHE as of November 1, 2023 are addressed in this article.Medicare Guidance Changes for E/M ServicesOctober 11th, 2023 - Wyn Staheli
2023 brought quite a few changes to Evaluation and management (E/M) services. The significant revisions as noted in the CPT codebook were welcome changes to bring other E/M services more in line with the changes that took place with Office or Other Outpatient Services a few years ago. As part of CMS’ Medicare Learning Network, the “Evaluation and Management Services Guide” publication was finally updated as of August 2023 to include the changes that took place in 2023. If you take a look at the new publication (see references below),....Can We Score Interpretation of an EKG Towards E/M Medical Decision Making?October 10th, 2023 - Aimee Wilcox
When EKGs are performed in the facility setting or even in the physician's office, what are the requirements for reporting the service and who gets credit for scoring data points for Evaluation and Management (E/M) medical decision making (MDM)? Let's take a look at a few coding scenarios related to EKG services to get a better understanding of why this can be problematic.Accurately Reporting Signs and Symptoms with ICD-10-CM CodesOctober 5th, 2023 - Aimee Wilcox
Coders often find themselves unsure of when to report a sign or symptom code documented in the medical record. Some coders find their organization has an EHR that requires a working diagnosis, which is usually a sign or symptom, be entered to order a test or diagnostic study or image. Understanding the guidelines surrounding when signs and symptoms should be reported is the first step in correct coding so let's take a look at some scenarios.The 2024 ICD-10-CM Updates Include New Codes for Reporting Metabolic Disorders and Insulin ResistanceSeptember 19th, 2023 - Aimee Wilcox
Diabetes is a chronic disease that just seems to consistently be increasing instead of improving resulting in a constant endeavor by medical researchers to identify causal effects and possible treatments. One underlying or precipitating condition that scientists have identified as a precipitating factor in the development of diabetes is insulin resistance, which is a known metabolic disorder. As data becomes available through claims reporting, additional code options become possible with ICD-10-CM.Documenting and Reporting Postoperative VisitsSeptember 12th, 2023 - Aimee Wilcox
Sometimes we receive questions regarding documentation requirements for specific codes or coding requirements and we respond with information and resources to support our answers. The following question was recently submitted: Are providers required to report postoperative services on claims using 99024, especially if there is no payment for that service? What documentation is required if you are reporting an unrelated Evaluation and Management (E/M) service by the same physician during the postoperative period? Understanding Gastroesophageal Reflux Disease and ICD-10-CM CodingAugust 22nd, 2023 - Aimee Wilcox
Gastroesophageal reflux disease or GERD for short, is a disease that impacts millions of Americans on a weekly basis. Symptoms are uncomfortable, as are some of the tests used to diagnose it, but understanding the disease, tests, and treatments helps us better understand how to code the disease using ICD-10-CM codes.