hypertension and heart disease

surajdk

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HI, if hypertension and heart disease is mention in assessment, can we link and code I11 .9 series or we will code only I10 ?

Bcz

there is mentioned in guidelines

( The same heart conditions (I50.-, I51.4-I51.7, I51.89, I51.9) with hypertension are coded separately if the provider has ICD-10-CM Official Guidelines for Coding and Reporting FY 2020 Page 47 of 121 documented they are unrelated to the hypertension. )

please guide me this
 

mitchellde

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As stated before if the provider documents the patient has heart disease and the patient has HTN, with no other causation documented for the heart disease the coder does combine them to code as i11.- adding only a code for heart failure if mentioned.
ICD-10 CM guidelines state
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.
1) Hypertension with Heart Disease
Hypertension with heart conditions classified to I50.- or I51.4- I51.7, I51.89, I51.9, are assigned to a code from category I11, Hypertensive heart disease. Use additional code(s) from category I50, Heart failure, to identify the type(s) of heart failure in those patients with heart failure.
The same heart conditions (I50.-, I51.4-I51.7, I51.89, I51.9) with hypertension are coded separately if the provider has documented they are unrelated to the hypertension. Sequence according to the circumstances of the admission/encounter.
From the alpha section
Hypertension, hypertensive (accelerated) (benign) (essential) (idiopathic) (malignant) (systemic) I10
with
heart failure I11.0 (congestive)
heart involvement (conditions in I50.-, I51.4- I51.9 due to hypertension) - see Hypertension, heart
kidney involvement - see Hypertension, kidney
The with under the main term is what the guidelines is referring to. When the main term is followed by the word with the conditions indented under the word with are to be considered automatically causal to the main term. The guidelines the tells you it does not dot need to be documented by the provider.
If you are not reading your guidelines and using your code book you have missed important coding rules such as this.
 

surajdk

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As stated before if the provider documents the patient has heart disease and the patient has HTN, with no other causation documented for the heart disease the coder does combine them to code as i11.- adding only a code for heart failure if mentioned.
ICD-10 CM guidelines state
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.
1) Hypertension with Heart Disease
Hypertension with heart conditions classified to I50.- or I51.4- I51.7, I51.89, I51.9, are assigned to a code from category I11, Hypertensive heart disease. Use additional code(s) from category I50, Heart failure, to identify the type(s) of heart failure in those patients with heart failure.
The same heart conditions (I50.-, I51.4-I51.7, I51.89, I51.9) with hypertension are coded separately if the provider has documented they are unrelated to the hypertension. Sequence according to the circumstances of the admission/encounter.
From the alpha section
Hypertension, hypertensive (accelerated) (benign) (essential) (idiopathic) (malignant) (systemic) I10
with
heart failure I11.0 (congestive)
heart involvement (conditions in I50.-, I51.4- I51.9 due to hypertension) - see Hypertension, heart
kidney involvement - see Hypertension, kidney
The with under the main term is what the guidelines is referring to. When the main term is followed by the word with the conditions indented under the word with are to be considered automatically causal to the main term. The guidelines the tells you it does not dot need to be documented by the provider.
If you are not reading your guidelines and using your code book you have missed important coding rules such as this.
Thank you so much for your valuable feedback.
 
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