Wiki Hypertension and heart disease

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chesmith

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Can someone please clarify the correct/proper way to code a patient when it states the following:

1) ICD-10 2017 book
2) pt has both Hypertension and heart disease
3) documentation does not state a relationship between the two conditions.
4) for 2017 can we still assume a relationship between these two conditions like we can for HTN/CKD?

What I am reading in the guidelines for the 2017 book on page 671 it states "if there is no causal relationship, code the conditions separately"
In the past we have been directed to code a combo code from I11 but after reading this in 2017 book I am thinking that the physician MUST document a relationship between the 2 conditions in order to code the combo code from I11, otherwise we would code both conditions separately.

Please clarify and/or let me know if there has been an update to the 2017 book and guidelines on this issue.

thanks
Chesmith
 
I am not sure what code book you have and exactly the information on that page.. but here is what the 2017 guidelines specifically state. This is a clarification of the guideline for the word "with". It was not a new directive for 2017 only a clarification of ICD-10 CM rules implemented 2015.
a. Hypertension
The classification presumes a causal relationship between hypertension and heart involvement and between hypertension and kidney involvement, as the two conditions are linked by the term “with” in the Alphabetic Index. These conditions should be coded as related even in the absence of provider documentation explicitly linking them, unless the documentation clearly states the conditions are unrelated.
For hypertension and conditions not specifically linked by relational terms such as “with,” “associated with” or “due to” in the classification, provider documentation must link the conditions in order to code them as related.
 
I have the AAPC ICD-10-CM EXPERT for Physicians and Hospitals. I am reading from the front of section "chapter 9" under the title "Hang on to these hypertension coding tips for accurate claims" and the subtitle "Hypertension + Heart disease"

I understand the "with" guideline but why is this stated differently in the front section of the chapter portion.
 
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