Hypertensive Heart new ICD-10 guidelines confusion

SAMGARGAN

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The new 2017 official guidelines for ICD-10 regarding Hypertensive heart state Hypertension with heart conditions classified to I50.- or I51.4-I51.9, are assigned to a code from category I11.
But, in the tabular for I11 Hypertensive heart disease it reads INCLUDES any condition in I51.4-I51.9 . It doesn't mention I50.-. Do we go by the guidelines or the tabular?
 
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The new 2017 official guidelines for ICD-10 regarding Hypertensive heart state Hypertension with heart conditions classified to I50.- or I51.4-I51.9, are assigned to a code from category I11.
But, in the tabular for I11 Hypertensive heart disease it reads INCLUDES any condition in I51.4-I51.9 . It doesn't mention I50.-. Do we go by the guidelines or the tabular?

If the patient has hypertension and a heart condition classifiable to I51.4 - I51.9, then you are to code from I11.

I11.0 Hypertensive heart disease WITH heart failure has a "use additional" note that states "code to identify type of heart failure (I50.-)"

Code block I50 has a Code First note that states "heart failure due to hypertension (I11.0)".

So if the patient has hypertensive heart disease WITHOUT heart failure, you are to code I11.0 FIRST followed by the appropriate code from I50.-

If the patient does NOT have heart failure, then you would code as I11.9 Hypertensive heart disease without heart failure.

Codes from I11 are "combination" codes, so to speak, combining "any condition in I51.4-I51.9 due to hypertension" and hypertension itself. For example, if you coded I11.9, that would include both hypertension and the heart condition (from I51.4 - I51.9) in one code, so you would not re-report the heart condition code as it's already included.
 
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