ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesI11.0

I11.0

Billable

Hypertensive heart disease with heart failure

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

Code Description

ICD-10 I11.0 is a billable code used to indicate a diagnosis of hypertensive heart disease with heart failure.

Key Diagnostic Point:

Hypertensive heart disease with heart failure is a condition that arises from chronic hypertension, leading to structural and functional changes in the heart. The left ventricle often undergoes hypertrophy due to the increased workload imposed by elevated blood pressure. Clinically, patients may present with symptoms of heart failure, including dyspnea, fatigue, and edema. The anatomy involved primarily includes the heart, particularly the left ventricle, and the vascular system. Disease progression typically involves the transition from compensated heart failure, where the heart can still maintain adequate output, to decompensated heart failure, characterized by worsening symptoms and reduced cardiac function. Diagnostic considerations include a thorough clinical evaluation, echocardiography to assess ventricular function, and possibly cardiac MRI or CT for detailed anatomical insights. Blood pressure management and heart failure assessment are crucial in the diagnostic process, as well as ruling out other potential causes of heart failure.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires comprehensive evaluation of hypertension and heart failure
  • Treatment complexity: Involves multiple medication management and lifestyle modifications
  • Documentation requirements: Detailed clinical notes and diagnostic tests must be documented
  • Coding specificity: Requires precise coding to differentiate from other forms of heart disease

Audit Risk Factors

  • Common coding errors: Misclassification of heart failure type or stage
  • Documentation gaps: Incomplete records of hypertension management or heart failure symptoms
  • Billing challenges: Potential denials due to lack of clear linkage between hypertension and heart failure

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 ICD-10 Codes

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 with heart failure significantly impacts population health, contributing to increased morbidity and mortality rates. It is a leading cause of hospitalizations and healthcare utilization, particularly among older adults. Quality measures often focus on blood pressure control and heart failure management, highlighting the importance of effective treatment strategies. Epidemiologically, the prevalence of hypertension and its complications continues to rise, necessitating ongoing public health efforts to improve management and outcomes.

ICD-9 vs ICD-10

Hypertensive heart disease with heart failure significantly impacts population health, contributing to increased morbidity and mortality rates. It is a leading cause of hospitalizations and healthcare utilization, particularly among older adults. Quality measures often focus on blood pressure control and heart failure management, highlighting the importance of effective treatment strategies. Epidemiologically, the prevalence of hypertension and its complications continues to rise, necessitating ongoing public health efforts to improve management and outcomes.

Reimbursement & Billing Impact

reimbursement may vary based on the severity and management of both hypertension and heart failure.

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 I11.0?

I11.0 covers hypertensive heart disease specifically associated with heart failure, which includes left ventricular hypertrophy and heart failure symptoms resulting from chronic hypertension.

When should I11.0 be used instead of related codes?

I11.0 should be used when a patient has documented hypertension that has led to heart failure. It is distinct from I50 codes, which refer to heart failure without the direct association with hypertension.

What documentation supports I11.0?

Documentation should include a diagnosis of hypertension, evidence of heart failure symptoms, and any relevant diagnostic tests such as echocardiograms showing left ventricular hypertrophy.