I11.9
BillableHypertensive heart disease without heart failure
HCC Category Mapping
RxHCCHCC 187 — Hypertension
0.000What This Code Means
High blood pressure that has caused structural or functional damage to the heart, but without resulting in heart failure.
Coding Tips
- •Use I11.9 when hypertensive heart disease is documented without heart failure symptoms or findings
- •This includes left ventricular hypertrophy and other cardiac changes from chronic hypertension without heart failure
Clinical Significance
Hypertensive heart disease without heart failure captures cardiac disease (such as left ventricular hypertrophy, diastolic dysfunction, or other cardiac structural changes) attributed to chronic hypertension, but without the presence of heart failure. While this condition does not carry CMS-HCC weight, it represents an important clinical distinction from hypertensive heart failure.
Documentation Requirements
- ✓Documented diagnosis of hypertension
- ✓Documented cardiac disease attributed to or coexisting with hypertension (e.g., left ventricular hypertrophy, cardiomegaly)
- ✓Explicit statement that heart failure is NOT present, or absence of heart failure documentation
- ✓Echocardiographic or other cardiac imaging findings when available
- ✓Current antihypertensive medication regimen
- ✓Note: Per ICD-10 guidelines, coexistence of hypertension and heart disease assumes a causal relationship
Commonly Confused Codes
I10 — Essential hypertension without heart disease (use when no cardiac disease is documented)I11.0 — Hypertensive heart disease WITH heart failure (use when heart failure IS present)I13.10 — Hypertensive heart and CKD without heart failure (use when CKD is also present)I51.7 — Cardiomegaly (would be encompassed by I11.9 when hypertension coexists)I51.81 — Takotsubo syndrome (separate condition, not hypertensive heart disease)
Code Hierarchy
└I11Hypertensive heart disease└I11.9Hypertensive heart disease without heart failure
└I11.9Hypertensive heart disease without heart failure