Cardiology Coding Alert

Question:If documentation shows hypertensive heart disease and hypertensive kidney disease, do I have to report both, or can I just report the hypertensive heart disease?Texas SubscriberAnswer: You should report both the hypertensive heart disease and hypertensive kidney disease using a single code from 404.xx (Hypertensive heart and chronic kidney disease).ICD-9 guidelines state that you should "assume a relationship between the hypertension and the kidney disease, whether or not the condition is so designated."Choose the fourth digit of your 404.xx code based on whether the documentation indicates the hypertensive disease is malignant (0) or benign (1). Or if the documentation doesn't indicate either of those, choose fourth digit 9 (unspecified).You should base the fifth digit on the presence of heart failure and the stage of the chronic kidney disease. For example, note the definition of 404.03 (Hypertensive heart and chronic kidney disease; malignant; with heart failure and chronic kidney disease stage [...]