Thursday 26 May 2016
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BlueCWoodham HIM Solutions is a Revenue Cycle Management company specializing in HIM Services; Hospital inpatient and outpatient coding, education, CDI Services, RAC Audits and Interim HIM / Coding management in addition to providing assessments of HIM department processes and operational efficiencies.  We provide tailored solutions that recognize each facility is "unique" in their requirements.


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Hypertension coding in ICD-10-CM

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 Weekly ICD-10 Education

December 21st, 2015


Hypertension Coding in ICD-10-CM

When coding hypertension in ICD-10-CM, you will notice that it is no longer classified by type (benign, malignant, unspecified). Only one code exists for essential hypertension- I10.

For combination code reporting, there are specific guidelines.

CKD with Hypertension
 There is a presumed causal relationship between chronic kidney disease and hypertension and it is classified as hypertensive chronic kidney disease unless specified otherwise. Codes from category I12, Hypertensive chronic kidney disease and NI8 Chronic kidney disease will be assigned.

 Heart Disease with Hypertension
  Heart conditions classified to I50.- or I51.4-I51.9, are assigned a code from I11, Hypertensive heart disease, when a causal relationship is stated (due to hypertension) or implied (hypertensive). Use an additional code from category I50, Heart failure, to identify the type of heart failure in those patient with heart failure.
 The same heart conditions (I50.-, I51.4-I51.9) with hypertension, but without a stated causal relationship, are coded separately.

 Hypertensive Heart and Chronic Kidney Disease
    Assign codes from combination category I13, Hypertensive heart and chronic kidney disease when the patient has both hypertensive CKD (assumed relationship) and hypertensive heart disease (documented causal relationship). Additional codes from N18 CKD, and I50 heart failure (if present).

 Hypertension, Secondary

Secondary hypertension is due to an underlying condition. Two codes are required: one to identify the underlying etiology and one from category I15 to identify the hypertension. Sequencing of codes is determined by the reason for admission/encounter. 

2016 Official ICD-10-CM Coding Guidelines Section I.C.9.a



Tip of the Week

Gestational Diabetes and Oral Medication

The 6th character choices for code O24.4 Gestational diabetes are diet controlled, insulin controlled and unspecified control. ICD-10-CM does not currently provide a unique code for gestational diabetes controlled with oral medication. Therefore, assign code O24.419 Gestational diabetes mellitus in pregnancy, unspecified control with the addition of Z79.899, Other long-term (current) drug therapy.

Ref Coding Clinic 4th Qtr. 2015 pg. 34.

ICD-10 questions or topics you would like to
see addressed in future education?

Kristin Orozco
Manager of Coding Compliance and Education

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