Cardiology Coding Alert

Question: I’m new to cardiology coding, and I was wondering if there are different codes you should report if the patient has hypertension and stage 2 chronic kidney disease (CKD) without heart failure versus if the patient has hypertension and stage 2 CKD with heart failure? And, someone in the office said we must also include the stage of the patient’s CKD. Is this true?

Ohio Subscriber

Answer: Yes. There are different codes you would look for with hypertension and stage 2 CKD without heart failure versus with heart failure.

Without heart failure: For hypertension and stages 1-4 CKD, without heart failure, you would report I13.10 (Hypertensive heart and chronic kidney disease without heart failure, with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease).

CKD stage: You should also report N18.2 (Chronic kidney disease, stage 2 (mild)) to identify the stage of CKD.

With heart failure: On the other hand, say the cardiologist documents that the patient has hypertension with stage 2 CKD and chronic systolic congestive heart failure. In this case, you should report I13.0 (Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease). Additionally, according to the ICD-10 Official Guidelines for Coding and Reporting, if the cardiologist documents that heart failure is present, you should also report an additional code from category I50- (Heart failure) to identify the type of heart failure. So, you should report I50.22 (Chronic systolic (congestive) heart failure) to indicate the type of heart failure. And, don’t forget to report N18.2 as a secondary code to identify the stage of CKD.

Don’t miss: The codes in category I13- (Hypertensive heart and chronic kidney disease) are combination codes, which include hypertension, heart disease, and CKD, according to the guidelines. Therefore, if a patient has hypertension, heart disease, and CKD, you should report the correct code from category I13-, not the individual codes for hypertension, heart disease, and chronic kidney disease, or any options from I11- (Hypertensive heart disease) or I12- (Hypertensive chronic kidney disease), per the guidelines.