I11.0 Hypertensive heart disease with heart failure

Billable ICD-10-CM code, FY2026.

Applicable to

• Hypertensive heart failure

Use additional code

• code to identify type of heart failure (I50.-)

Applies from I11 Hypertensive heart disease

Includes

• any condition in I50.- or I51.4-I51.7, I51.89, I51.9 due to hypertension

Risk adjustment (HCC)

• CMS-HCC V28: HCC 226 — Heart Failure, Except End-Stage and Acute
• CMS-HCC V22: HCC 85 — Congestive Heart Failure
• RxHCC V08: HCC 186 — Heart Failure
• ESRD V24: HCC 85

MS-DRG index

Defines the logic of DRG(s) 291-293 in MDC 05.

Approximate ICD-9-CM (GEMs)

• 402.01 Malignant hypertensive heart disease with heart failure (approximate)
• 402.11 Benign hypertensive heart disease with heart failure (approximate)
• 402.91 Unspecified hypertensive heart disease with heart failure (approximate)

Code annotations containing back-references to I11.0

Back-references to I11.0

• Code First: I50 Heart failure ("heart failure due to hypertension (I11.0)")

Back-references to I11

• Code Also: I16 Hypertensive crisis ("any identified hypertensive disease (I10-I15, I1A)")
• Type 1 Excludes: I51.5 Myocardial degeneration ("myocardial degeneration due to hypertension (I11.-)")
• Type 1 Excludes: I51.7 Cardiomegaly ("cardiomegaly due to hypertension (I11.-)")
• Code Also: I67.4 Hypertensive encephalopathy ("hypertensive heart disease (I11.-)")
• Code Also: I87.2 Venous insufficiency (chronic) (peripheral) ("hypertensive heart disease (I11.-)")
• Use Additional: O10.1 Pre-existing hypertensive heart disease complicating pregnancy, childbirth and the puerperium ("code from I11 to identify the type of hypertensive heart disease")

Diagnosis Index entries for I11.0

• Hypertension, hypertensive (accelerated) (benign) (essential) (idiopathic) (malignant) (systemic) › with › heart failure (congestive)
• Hypertension, hypertensive (accelerated) (benign) (essential) (idiopathic) (malignant) (systemic) › heart (disease) (conditions in I51.4-I51.9 due to hypertension) › with › heart failure (congestive)

Nearby codes

• I11 Hypertensive heart disease
• I11.0 Hypertensive heart disease with heart failure (this code)
• I11.9 Hypertensive heart disease without heart failure