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Causaul relationship of hypertension and heart failure

  1. Default Causaul relationship of hypertension and heart failure
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    Which of the following would be assigned to code I11.0, Hypertensive heart disease with heart failure?
    a. Left heart failure with benign hypertension
    b. Hypertensive cardiomegaly
    c. Congestive heart failure due to hypertension 
    d. All of the above


    Is the answer C or is the answer A and C, based on the rule stated for causal relationships between hypertension and heart failure?

    Thanks everyone for your input.

  2. #2
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    Columbia, MO
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    A stated causal relationship is either hypertensive or due to. The index states:
    Hypertension
    with
    heart involvement (conditions in I51.4- I51.9 due to hypertension) - see Hypertension, heart

    heart (disease) (conditions in I51.4-I51.9 due to hypertension) I11.9
    with
    heart failure (congestive) I11.0
    Based on the index listing now decide the correct answer.

    Debra A. Mitchell, MSPH, CPC-H

  3. Default
    Thank you, Debra. So, you are reading the guidelines "literally" and only the words hypertensive or due to can link the heart failure? Guidelines state that the word with also means due to. I have a specific example in my Optum ICD-10 book that says hypertensive heart disease WITH heart failure is coded as I11.0 and I50.1. And the explanation is because a causal relationship is stated allowing the reporting of codes from catergory I11, and to use additional code to identify type of heart failure. Based on chapter guidelines this means congestive heart failure is coded as I11.0 and I50.9. I do understand that because the word congestive is in parenthesis some think the I50.9 is redundant. It is my understanding that I11.0 does include congestive HF but also other types of HF. Especially with the example given in the book. I say the answer is A and C. If I am understanding your response, you say the answer is C?

  4. #4
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    yes "with" means the same as "due to" the answer is C as I read the question, the I11.0 will prompt you to add a code for the heart failure.

    Debra A. Mitchell, MSPH, CPC-H

  5. Default
    Can you explain why you don't think A is also a valid answer to the question? I am curious to know your rationale, if you don't mind.

  6. #6
    Talking A and C both are right answers
    I believe A and C both are right answers, Because I11.0 is code for Hypertensive heart disease with heart failure, the code also says to use an additional code to specify the type of heart failure(which can be left heart failure or congestive).
    Also in ICD-10 code for hypertension and malignant hypertension has same code range and represented in parenthesis which means:Parentheses are used in both the Alphabetic Index and Tabular List to enclose supplementary words that may be present or absent in the statement of a disease or procedure without affecting the code number to which it is assigned.
    Hope this may help you.

  7. Default
    Thank you, Ajesh. That is how I am understanding the question and the coding.

  8. #8
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    I believe that whoever wrote this question is wanting you to use the index and the guidelines. If you look under the word failure, then heart there is no listing under the word "with" for hypertension. So if written this way you do not combine them. Where if you look under the word hypertension, then "with'. You do see heart failure , and following the guidelines for a listing in this manner you do combine them. So the correct answer with the choices given as written is C.

    Debra A. Mitchell, MSPH, CPC-H

  9. Default
    It looks like hypertensive cardiomegaly would be included also, according to the "includes" note under I11 which says includes any condition in I51.4-I51.9 due to hypertension and cardiomegaly is I51.7.

  10. #10
    Default With heart failure and without heart failure
    Quote Originally Posted by sxcoder1 View Post
    It looks like hypertensive cardiomegaly would be included also, according to the "includes" note under I11 which says includes any condition in I51.4-I51.9 due to hypertension and cardiomegaly is I51.7.
    Question is I11.0, which says with heart failure. Cardiomegaly is included in the code range but it may include in I11.9, without heart failure

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