ICD-10 Coding for Hypertension with ESRD(I12.0, N18.6)
Complete ICD-10-CM coding and documentation guide for Hypertension with ESRD. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hypertension with ESRD
I10-I15Primary Range
Hypertensive diseases
This range includes codes for hypertension and related conditions, including hypertensive chronic kidney disease.
Chronic kidney disease (CKD)
This range includes codes for chronic kidney disease stages, including ESRD.
Type 2 diabetes mellitus
This range includes codes for diabetes with complications, relevant when diabetes contributes to ESRD.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I12.0 | Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end-stage renal disease | Use when hypertension is documented as causing or contributing to ESRD. |
|
| N18.6 | End-stage renal disease | Use for patients with ESRD, typically requiring dialysis. |
|
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: ICD-10 code for hypertension with ESRD
Essential facts and insights about Hypertension with ESRD
Primary ICD-10-CM Codes for hypertension with esrd
Decision Criteria
clinical Criteria
- Hypertension documented as contributing to CKD/ESRD.
coding Criteria
- Sequence I12.0 before N18.6 unless heart disease is present.
Applicable To
- Hypertension with stage 5 CKD
- Hypertension with ESRD
Excludes
- Hypertensive heart and CKD (I13.-)
Clinical Validation Requirements
- GFR <15 mL/min
- Documentation linking hypertension to CKD/ESRD
Code-Specific Risks
- Incorrectly using I10 for essential hypertension when ESRD is present.
Coding Notes
- Ensure documentation explicitly links hypertension to ESRD unless otherwise stated.
N18.6 - End-stage renal disease
Use for patients with ESRD, typically requiring dialysis.
Applicable To
- ESRD
Excludes
- Chronic kidney disease stage 1-5 (N18.1-N18.5)
Clinical Validation Requirements
- GFR <15 mL/min
- Dialysis status
Coding Notes
Always document dialysis status if applicable.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Dependence on renal dialysis
Z99.2Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Hypertension with ESRD to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I12.0.
Impact
Clinical: Inaccurate representation of patient treatment., Regulatory: Potential audit issues., Financial: Missed reimbursement opportunities.
Mitigation Strategy
Always include Z99.2 when applicable., Review dialysis documentation regularly.
Impact
Reimbursement: Incorrect DRG assignment may reduce reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Always use I12.0 when hypertension contributes to ESRD.
Impact
I12.0 must precede N18.6 unless heart disease is present.
Mitigation Strategy
Regular training on sequencing rules.
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 Hypertension with ESRD, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hypertension with ESRD
Use these documentation templates to ensure complete and accurate documentation for Hypertension with ESRD. These templates include all required elements for proper coding and billing.
Nephrology Consultation
Specialty: NephrologyRequired Elements
- Reason for consultation
- BP trends
- Dialysis details
- Linkage statements
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Hypertension with ESRD? Ask your questions below.