Results 1 to 5 of 5

Hypertension with CKD

  1. #1
    Red face Hypertension with CKD
    Medical Coding Books
    Hi everyone,
    I code for a Nephrology office with 4 physicians and a Physician Assistant, my question is when I see a primary diagnosis of chronic kidney disease with a secondary dx of hypertension, does that itself give me enough information to make the second diagnosis 403.xx instead of 401.x. I'm not able to find anything that definitively states that this is the correct way to code. I understand that ICD-9 states to assume a cause and effect relationship (pgs. 9-10) but it's hard to wrap my head around an assumption when it was drilled into me from my education that a good coder does not assume anything. I would really appreciate an experienced nephrology coder's advice on this.

  2. #2
    Default HTN & chronic kidney disease
    "When the diagnostic statement includes both hypertension and chronic kidney disease, ICD-9-CM usualyy assumes there is a cause-and effect relationship." (Faye Brown 2010 p 347) The relationship does not need to be documented by the physician.

  3. #3
    Columbia, MO
    The coding guidelines will tell you this is automatically 403.xx and your CKD 585.x is the secondary code.

    Debra A. Mitchell, MSPH, CPC-H

  4. #4
    Quote Originally Posted by mitchellde View Post
    The coding guidelines will tell you this is automatically 403.xx and your CKD 585.x is the secondary code.
    Debra is correct... I remember when I first started billing/coding I never read the coding guidelines in the front of the ICD-9, I was never told/trained to do so until I got connected with the AAPC and decided to actually read the the ICD-9 front from to back- It's amazing what you learn. Now every year I read thru it to make sure I know what's going on and I highlight things pertinent to what I code and bill for on a daily basis.

    I too had trouble at first understanding why the relationship was assumed but it is drilled into my head now... after all these years....

    Just my 2 cents.
    Roxanne Thames CPC, CPC-I, CEMC

    "Remember the greatest gift is not found in the store but in the heart of true friends"

  5. #5
    Thanks everyone,
    It's good to know I'm not alone in my ever evolving training! I am using the 403.XX codes with my 585-587 codes and I'm wading through the front section of my ICD-9 now. Looking forward to the next challenge!

Similar Threads

  1. Essential Hypertension Vs Pulmonary Hypertension
    By tharal in forum Diagnosis Coding
    Replies: 2
    Last Post: 09-19-2013, 07:57 PM
  2. CKD in the setting of hypertension
    By magnusrune in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 04-24-2012, 10:27 PM
  3. Ckd
    By arizona1 in forum Urology
    Replies: 0
    Last Post: 06-04-2010, 10:05 AM
  4. Ckd
    By arizona1 in forum Medicare Regulations
    Replies: 0
    Last Post: 06-04-2010, 10:03 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.