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ICD-10 Guide
ICD-10 CodesI11

I11

Non-billable

Hypertensive heart disease

BILLABLE STATUSNo
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 I11 is a used to indicate a diagnosis of hypertensive heart disease.

Key Diagnostic Point:

Hypertensive heart disease (I11) refers to heart conditions that arise as a result of hypertension, which is defined as persistently elevated blood pressure. This condition can lead to various complications, including left ventricular hypertrophy, heart failure, and ischemic heart disease. The anatomy involved primarily includes the heart and blood vessels, particularly the left ventricle, which may thicken due to the increased workload from high blood pressure. Disease progression often involves a gradual deterioration of cardiac function, leading to symptoms such as shortness of breath, fatigue, and chest pain. Diagnostic considerations for I11 include a thorough patient history, physical examination, and diagnostic tests such as echocardiograms, electrocardiograms, and blood pressure monitoring. It is crucial to differentiate hypertensive heart disease from other heart conditions to ensure appropriate management and treatment strategies.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires comprehensive evaluation of hypertension and cardiac function.
  • Treatment complexity: Involves managing both hypertension and heart disease, often necessitating a multidisciplinary approach.
  • Documentation requirements: Detailed documentation of hypertension management and cardiac assessments is essential.
  • Coding specificity: Requires accurate coding to reflect the specific type of hypertensive heart disease.

Audit Risk Factors

  • Common coding errors: Misclassification of the type of heart disease or hypertension.
  • Documentation gaps: Incomplete records regarding blood pressure readings and cardiac assessments.
  • Billing challenges: Potential denials due to insufficient documentation linking hypertension to heart disease.

Specialty Focus

Medical Specialties

Cardiology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Internal Medicine

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Hypertensive heart disease significantly impacts population health, contributing to increased morbidity and mortality rates associated with cardiovascular diseases. Effective management of hypertension can reduce the incidence of heart disease, improve quality measures, and decrease healthcare utilization patterns. Epidemiologically, the prevalence of hypertension and its complications underscores the need for targeted interventions and public health initiatives aimed at controlling blood pressure and promoting heart health.

ICD-9 vs ICD-10

Hypertensive heart disease significantly impacts population health, contributing to increased morbidity and mortality rates associated with cardiovascular diseases. Effective management of hypertension can reduce the incidence of heart disease, improve quality measures, and decrease healthcare utilization patterns. Epidemiologically, the prevalence of hypertension and its complications underscores the need for targeted interventions and public health initiatives aimed at controlling blood pressure and promoting heart health.

Reimbursement & Billing Impact

reimbursement. Regular audits and training on coding best practices can help mitigate billing challenges.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for I00-I99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for I00-I99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by I11?

I11 encompasses conditions such as hypertensive heart failure, hypertensive heart disease with left ventricular hypertrophy, and other heart conditions directly related to chronic hypertension.

When should I11 be used instead of related codes?

I11 should be used when there is clear evidence of heart disease resulting from hypertension, as opposed to using I10 for essential hypertension alone or I50 for heart failure without a direct link to hypertension.

What documentation supports I11?

Documentation must include a diagnosis of hypertension, evidence of heart disease (such as echocardiogram results), and a treatment plan addressing both conditions.