ICD-10 Coding for Diabetes with Hypertension(E11.22, I12.9)
Complete ICD-10-CM coding and documentation guide for Diabetes with Hypertension. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Diabetes with Hypertension
E11-E14Primary Range
Diabetes mellitus
Covers diabetes mellitus codes, including those with complications such as nephropathy.
Hypertensive diseases
Includes codes for hypertension, including those related to kidney disease.
Chronic kidney disease (CKD)
Covers CKD stages, which are relevant when coding diabetes with hypertension.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E11.22 | Type 2 diabetes mellitus with diabetic chronic kidney disease | Use when CKD is documented as a complication of diabetes. |
|
| I12.9 | Hypertensive chronic kidney disease with stage 1 through stage 4 CKD, or unspecified CKD | Use when CKD is documented as related to hypertension. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: How do you code diabetes with hypertension and CKD?
Essential facts and insights about Diabetes with Hypertension
Primary ICD-10-CM Codes for diabetes with hypertension
Decision Criteria
clinical Criteria
- Presence of diabetic nephropathy
Applicable To
- Diabetic nephropathy
Clinical Validation Requirements
- A1C ≥6.5%
- eGFR <60 mL/min/1.73m²
- Proteinuria
Code-Specific Risks
- Incorrectly omitting CKD stage code
- Not linking CKD to diabetes
Coding Notes
- Ensure CKD is documented as related to diabetes.
I12.9 - Hypertensive chronic kidney disease with stage 1 through stage 4 CKD, or unspecified CKD
Use when CKD is documented as related to hypertension.
Applicable To
- Hypertensive nephropathy
Excludes
- Hypertensive heart and CKD (I13.-)
- Hypertensive retinopathy (H35.03-)
Clinical Validation Requirements
- BP ≥130/80 mmHg
- eGFR <90 mL/min/1.73m²
Coding Notes
Ensure CKD is documented as related to hypertension.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Diabetes with Hypertension to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E11.22.
Impact
Clinical: Inadequate treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Always document eGFR and CKD stage., Review lab results for CKD indicators.
Impact
Reimbursement: Incorrect coding may lead to lower reimbursement., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate data on patient conditions.
Mitigation Strategy
Always use I12.9 when CKD is documented with hypertension.
Impact
Failure to document CKD stage can lead to audit flags.
Mitigation Strategy
Implement checklist for CKD documentation in patient records.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Diabetes with Hypertension, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Diabetes with Hypertension
Use these documentation templates to ensure complete and accurate documentation for Diabetes with Hypertension. These templates include all required elements for proper coding and billing.
Diabetes with Hypertension and CKD
Specialty: Primary CareRequired Elements
- Type of diabetes
- CKD stage
- Hypertension status
- A1C levels
- Blood pressure readings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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