Hypertension ICD-10 Codes: Complete Guide to I10-I16
- Jan 31, 2025
Hypertension (high blood pressure) is one of the most commonly coded conditions in healthcare, affecting nearly half of American adults. Accurate coding of hypertension and its complications is essential for proper reimbursement and clinical documentation. This guide covers all ICD-10-CM hypertension codes from I10 through I16.
Quick Reference: Hypertension Code Categories
| Category | Code Range | Description |
|---|---|---|
| I10 | I10 | Essential (primary) hypertension |
| I11 | I11.0-I11.9 | Hypertensive heart disease |
| I12 | I12.0-I12.9 | Hypertensive chronic kidney disease |
| I13 | I13.0-I13.2 | Hypertensive heart and CKD |
| I15 | I15.0-I15.9 | Secondary hypertension |
| I16 | I16.0-I16.9 | Hypertensive crisis |
I10: Essential (Primary) Hypertension
I10 is the most commonly used hypertension code, representing essential or primary hypertension without documented heart disease or chronic kidney disease.
I10 Includes:
- High blood pressure
- Hypertension (arterial) (benign) (essential) (malignant) (primary) (systemic)
- Hypertensive vascular disease
- Hypertensive vascular degeneration
When to use I10:
- Patient has documented hypertension without heart disease or CKD
- Blood pressure medications are prescribed for hypertension
- Documentation states "HTN," "hypertension," or "high blood pressure"
Important: I10 should NOT be used when:
- Hypertensive heart disease is documented (use I11)
- Hypertensive chronic kidney disease is documented (use I12)
- Both heart and kidney disease are present with hypertension (use I13)
- Hypertension is secondary to another condition (use I15)
I11: Hypertensive Heart Disease
The I11 category is used when both hypertension and heart disease are documented and the conditions have a causal relationship.
I11 Code Options
| Code | Description | Use Additional Code |
|---|---|---|
| I11.0 | Hypertensive heart disease with heart failure | I50.- for type of heart failure |
| I11.9 | Hypertensive heart disease without heart failure | N/A |
ICD-10-CM presumes a causal relationship between hypertension and heart disease when both are documented, unless the provider specifically documents they are unrelated.
Heart Conditions Included
When documented with hypertension, these heart conditions should be coded with I11:
- Cardiomegaly
- Cardiomyopathy
- Cardiovascular disease
- Heart disease NOS
- Heart failure
- Left ventricular hypertrophy (LVH)
Coding Example: Hypertensive Heart Failure
Documentation: Patient with hypertension and congestive heart failure (CHF).
Codes:
1. I11.0 - Hypertensive heart disease with heart failure
2. I50.9 - Heart failure, unspecified (or more specific I50 code if documented)
I12: Hypertensive Chronic Kidney Disease
The I12 category is used when hypertension and chronic kidney disease (CKD) are both documented.
I12 Code Options
| Code | Description | CKD Stage |
|---|---|---|
| I12.0 | Hypertensive CKD with stage 5 CKD or ESRD | Stage 5 or ESRD |
| I12.9 | Hypertensive CKD with stage 1-4 CKD or unspecified | Stages 1-4 or NOS |
ICD-10-CM presumes a causal relationship between hypertension and CKD when both are documented, unless the provider specifically documents they are unrelated.
Required Additional Codes
Always use an additional code to identify the stage of CKD:
- N18.1 - CKD stage 1
- N18.2 - CKD stage 2 (mild)
- N18.3 - CKD stage 3 (moderate)
- N18.4 - CKD stage 4 (severe)
- N18.5 - CKD stage 5
- N18.6 - End stage renal disease (ESRD)
Coding Example: HTN with CKD Stage 3
Documentation: Patient with hypertension and CKD stage 3.
Codes:
1. I12.9 - Hypertensive chronic kidney disease with stage 1-4 CKD
2. N18.3 - Chronic kidney disease, stage 3 (moderate)
I13: Hypertensive Heart and Chronic Kidney Disease
The I13 category is used when hypertension exists with BOTH heart disease AND chronic kidney disease.
I13 Code Options
| Code | Description |
|---|---|
| I13.0 | Hypertensive heart and CKD with heart failure and stage 1-4 CKD or unspecified CKD |
| I13.10 | Hypertensive heart and CKD without heart failure, with stage 1-4 CKD or unspecified CKD |
| I13.11 | Hypertensive heart and CKD without heart failure, with stage 5 CKD or ESRD |
| I13.2 | Hypertensive heart and CKD with heart failure and stage 5 CKD or ESRD |
Required Additional Codes
For I13 codes, you must use additional codes to identify:
1. Type of heart failure (I50.-) when applicable
2. Stage of CKD (N18.-)
Coding Example: HTN with CHF and CKD Stage 4
Documentation: Patient with hypertension, congestive heart failure, and CKD stage 4.
Codes:
1. I13.0 - Hypertensive heart and CKD with heart failure and stage 1-4 CKD
2. I50.9 - Heart failure, unspecified
3. N18.4 - Chronic kidney disease, stage 4 (severe)
I15: Secondary Hypertension
Secondary hypertension codes are used when hypertension is caused by an underlying condition. The underlying condition must be coded in addition to the I15 code.
I15 Code Options
| Code | Description | Common Causes |
|---|---|---|
| I15.0 | Renovascular hypertension | Renal artery stenosis |
| I15.1 | Hypertension secondary to other renal disorders | Kidney disease, renal complications |
| I15.2 | Hypertension secondary to endocrine disorders | Cushing syndrome, pheochromocytoma, hyperaldosteronism |
| I15.8 | Other secondary hypertension | Drug-induced, sleep apnea-related |
| I15.9 | Secondary hypertension, unspecified | Cause documented as secondary but not specified |
Sequencing Rules
Code First the underlying condition:
- E24.- - Cushing syndrome
- E27.5 - Adrenomedullary hyperfunction (pheochromocytoma)
- Renal disorders causing hypertension
- Other causative conditions
Then code the secondary hypertension (I15.-)
Coding Example: Hypertension Due to Cushing Syndrome
Documentation: Patient with hypertension secondary to Cushing syndrome.
Codes:
1. E24.9 - Cushing syndrome, unspecified (code first)
2. I15.2 - Hypertension secondary to endocrine disorders
I16: Hypertensive Crisis
The I16 category captures acute, severe elevations in blood pressure that require urgent treatment.
I16 Code Options
| Code | Description | When to Use |
|---|---|---|
| I16.0 | Hypertensive urgency | Severely elevated BP without acute organ damage |
| I16.1 | Hypertensive emergency | Severely elevated BP WITH acute organ damage |
| I16.9 | Hypertensive crisis, unspecified | Crisis documented but urgency/emergency not specified |
Key Distinction: Urgency vs Emergency
Hypertensive Urgency (I16.0):
- Severely elevated blood pressure (typically >180/120 mmHg)
- No signs of acute target organ damage
- Can usually be treated orally over 24-48 hours
Hypertensive Emergency (I16.1):
- Severely elevated blood pressure
- Evidence of acute target organ damage (encephalopathy, stroke, MI, aortic dissection, pulmonary edema, acute kidney injury)
- Requires immediate IV treatment
Code Also Instructions
For hypertensive crisis, code also any identified hypertensive disease:
- I10 (essential hypertension)
- I11.- (hypertensive heart disease)
- I12.- (hypertensive CKD)
- I13.- (hypertensive heart and CKD)
Common Coding Scenarios
Scenario 1: Simple Hypertension Documentation: "HTN, controlled on lisinopril" Code: I10
Scenario 2: HTN with LVH Documentation: "Hypertension with left ventricular hypertrophy" Code: I11.9 (presumes causal relationship)
Scenario 3: HTN with CHF and CKD Stage 3 Documentation: "Patient has hypertension, CHF, and CKD stage 3" Codes: 1. I13.0 2. I50.9 3. N18.3
Scenario 4: Hypertensive Emergency with Stroke Documentation: "Hypertensive emergency with acute ischemic stroke" Codes: 1. I16.1 - Hypertensive emergency 2. I10 - Essential hypertension 3. I63.- - Cerebral infarction (specific stroke code)
Scenario 5: Controlled HTN Documentation: "Hypertension, well controlled" Code: I10 (controlled status does not change the code)
Frequently Asked Questions
What is the most common hypertension code? I10 (Essential hypertension) is the most commonly used code, as it covers primary hypertension without documented complications.
Should I code both I10 and I11? No. I11 codes include hypertension - you do not need a separate I10 code when using I11, I12, or I13.
How do I code uncontrolled hypertension? Use the same hypertension code (I10, I11, I12, or I13) regardless of control status. ICD-10-CM does not have separate codes for controlled vs uncontrolled hypertension.
Can I use I10 with I13? No. The I13 combination codes include essential hypertension. Using I10 with I13 would be redundant.
What if HTN and heart disease are documented but not causally related? If the provider explicitly states the conditions are unrelated, code each condition separately (I10 for hypertension, and the appropriate code for the heart condition).
Related Resources
- Search hypertension codes
- Browse Chapter 9: Circulatory System
- Heart failure codes (I50)
- Chronic kidney disease codes (N18)
- AI Clinical Note Analyzer - Extract hypertension codes from clinical notes
---
Last updated: January 2025. Code data reflects ICD-10-CM 2026 version.