by Wyn Staheli, Director of Content - innoviHealth
Nov 25th, 2019
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.
| Condition(s) | Coding Guidance |
| Essential (primary) | 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.
Note: If there is acute renal failure, add that code. |
| w/ chronic kidney disease | Patient has CKD classifiable with N18.-
|
| 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
|
| 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. |
| w/ pregnancy |
|
| w/ pulmonary involvement | |
| cerebrovascular disease | Code first applicable code from categories I60-I69, then report applicable hypertension code. |
| hypertensive crisis | Blood pressure is 180/120 or greater. Use code from I16.-
|
| secondary | 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. |
References/Resources
About Wyn Staheli, Director of Content - innoviHealth
Wyn Staheli is the Director of Content Research for innovHealth. She has over 30 years of experience in the healthcare industry. With her degree in Management Information Systems (MIS), she has been a programmer for a large insurance carrier as well as a California hospital system. She is also the author and editor of many medical resource books and the founder of InstaCode Institute.
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