by Wyn Staheli, Director of Research
November 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.
|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/ 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.|