# Coding Hypertensive heart and CKD 404.XX - Need clarification if it appropriate



## LindaKrarup (Dec 3, 2009)

Need clarification if it appropriate to use the combination code 404.xx when a patient has CKD with hypertension and also has congestive heart failure (again dx of HTN is listed separately).  Can you code 404.xx this if the HTN and CHF are not listed together or stated as hypertensive heart disease or should they be coded separately?


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## jholt12 (Dec 3, 2009)

Hello Linda,
 I had attended a talk from a guy who was certified in that specialty. If you need his name and credentials, I will have to look for the packet I received from him. But he had stated that for hypertensive heart disease or ckd it actually needs to state hypertensive heart disease or heart disease due to hypertention. Also that these codes are used mostly by a specialist. (Cardiologist) since the family practice/primary care doctors wouldn't normal have run the tests to know that the hypertension was the cause of those issues. I hope that helps.


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## tlg5371 (Feb 7, 2010)

There is an automatic relationship with HTN and CKD, but not with heart disease and HTN, your doc would have to specify the heart disease is due to hypertension or state hypertensive CHF. So is your patient has HTN, CHF and CKD you would assign CHF as 428.0 and the HTN and CKD as such:  403.xx and 585.x.


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