Wiki Combo Codes for CKD,Heart failure with Htn

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Hi All,

I’m having an doubt on this topic. When patient comes for Chest pain then it leads Heart failure as Final Dx. Patient already having Chronic condition like CKD and HTN. Shall we Code Combo for this? Please Explain

Balaji K
 
According to the ICD-10 CM Official Coding Guidelines 2017, ""Heart conditions classified to I50.- or I51.4-I51.9, are assigned to a code from category I11, hypertensive heart disease, when a causal relationship is stated (due to HTN) or implied (hypertensive)". If the a causal relationship is not stated, the HTN and heart failure should be separately coded.

Unlike the heart failure and hypertension, a relationship is assumed between CKD and HTN. According to the ICD-10 CM Official Coding Guidelines 2017 "Assume a relationship between the hypertension and the chronic kidney disease, whether or not the condition is so designated"

Ashley Morin CCA, CPC-A
 
According to the ICD-10 CM Official Coding Guidelines 2017, ""Heart conditions classified to I50.- or I51.4-I51.9, are assigned to a code from category I11, hypertensive heart disease, when a causal relationship is stated (due to HTN) or implied (hypertensive)". If the a causal relationship is not stated, the HTN and heart failure should be separately coded.

Unlike the heart failure and hypertension, a relationship is assumed between CKD and HTN. According to the ICD-10 CM Official Coding Guidelines 2017 "Assume a relationship between the hypertension and the chronic kidney disease, whether or not the condition is so designated"

Ashley Morin CCA, CPC-A

I believe you are actually quoting the 2016 guidelines. If you are quoting this from your 2017 ICD-10 book, due to publishing deadlines, most publishers publish the previous year's guidelines in their books. I know this has been discussed on the forum in the past and I just double checked my 2017 booked published by Optum and confirmed this.

One of the 2017 changes was that a causal relationship is assumed and doesn't need to be specifically stated for hypertension and heart failure (just like hypertension with ckd). The 2017 guidelines state that, "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."

This is true for I11, I12, and I13 categories.

This is found on pages 12, 42-43 of the 2017 guidelines.

https://www.cms.gov/Medicare/Coding/ICD10/Downloads/2017-ICD-10-CM-Guidelines.pdf
 
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